NPIMap

Organization Active NPI

Wellington Physician Alliances Inc

  • Internal Medicine Physician
  • Wellington, FL
National Provider Identifier
1275798472
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
WELLINGTON PHYSICIAN ALLIANCES INC
Practice address
10111 Forest Hill Blvd RM 231
Wellington, FL 33414-6157
Phone
(561) 472-2590
Fax
(561) 227-0161
NPI assigned
Jul 28, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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

Authorized official

Name
Mr. Todd Evans
Title
VP
Phone
(610) 768-3300

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X

Addresses

Primary practice location

10111 Forest Hill Blvd RM 231
Wellington, FL 33414-6157

Mailing address

367 S Gulph Rd
King of Prussia, PA 19406-3121

Other identifiers 4

IdentifierTypeStateIssuer
9359550OtherFLAETNA
99817OtherFLBCBS
000591200MedicaidFL
DR7639OtherFLRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090313000086 FL Part B Supplier - Clinic/Group Practice 4587720743 Receives reassigned benefits from 10 practitioners
Practice locations: Palm Springs, FL; Wellington, FL

National Provider Directory

National Provider Directory

Locations

1397 Medical Park Blvd
Wellington, FL 33414

10111 Forest Hill Blvd
Rm 231
West Palm Beach, FL 33414
Phone (561) 472-2590

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1217203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729728000000",
    "number": "1275798472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "367 S GULPH RD",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194063121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10111 FOREST HILL BLVD RM 231",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334146157",
            "telephone_number": "561-472-2590",
            "fax_number": "561-227-0161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLINGTON PHYSICIAN ALLIANCES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-28",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "610-768-3300",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9359550",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "99817",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000591200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DR7639",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.