Organization Active NPI

Diverse Medical Professionals, PA

  • Internal Medicine Physician
  • Boynton Beach, FL
National Provider Identifier
1275309932
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
DIVERSE MEDICAL PROFESSIONALS, PA
Practice address
1200 S Federal Hwy Ste 302
Boynton Beach, FL 33435-6058
Phone
(561) 509-9382
Fax
(561) 509-9362
NPI assigned
Dec 4, 2023
Last updated
Dec 4, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ryan Rosen, MDNPI 1255510509
Title
Physician/Medical Director
Phone
(561) 509-9382

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary
Physical Medicine & Rehabilitation Physician 208100000X NU
Pain Medicine Physician 208VP0000X NU

Addresses

Primary practice location

1200 S Federal Hwy Ste 302
Boynton Beach, FL 33435-6058

Mailing address

1200 S Federal Hwy Ste 302
Boynton Beach, FL 33435-6058
Phone (561) 509-9382

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2024941Diverse Medical Professionals PA1200 South Federal Hwy Suite 302, Boynton Beach, FL 33435Certificate of waiverMay 25, 2027

National Provider Directory

National Provider Directory

Locations

1200 S Federal Hwy
Ste 302
Boynton Beach, FL 33435
Phone (561) 509-9382

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1701648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701648000000",
    "number": "1275309932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 S FEDERAL HWY STE 302",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334356058",
            "telephone_number": "561-509-9382",
            "fax_number": "561-509-9362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S FEDERAL HWY STE 302",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334356058",
            "telephone_number": "561-509-9382",
            "fax_number": "561-509-9362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSE MEDICAL PROFESSIONALS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-04",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-03",
        "status": "A",
        "authorized_official_last_name": "ROSEN",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "PHYSICIAN/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "561-509-9382",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.