NPIMap

Organization Active NPI

Soma Medical Center PA 6

  • Primary Care Clinic/Center
  • Palm Springs, FL
National Provider Identifier
1295145704
Registry record updated Apr 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
ME0076971 Issued in FL
Legal business name
SOMA MEDICAL CENTER PA 6
Practice address
3580 Lake Worth Rd
Palm Springs, FL 33461-4029
Phone
(561) 275-1155
Fax
(561) 275-1156
NPI assigned
May 6, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2022

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

Authorized official

Name
Rafael O Nunez, MD
Title
Medical Director
Phone
(561) 275-1155

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X ME0076971 FL Primary

Addresses

Primary practice location

3580 Lake Worth Rd
Palm Springs, FL 33461-4029

Mailing address

3580 Lake Worth Rd
Palm Springs, FL 33461-4029
Phone (561) 275-1155

Other identifiers 1

IdentifierTypeStateIssuer
255695200MedicaidFL

Other names 1

  • SOMA MEDICAL CENTER PA 6 Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220823000192 FL Part B Supplier - Clinic/Group Practice 6406239540 Receives reassigned benefits from 7 practitioners
1 other NPI on this enrollment
Practice locations: Boynton Beach, FL; Palm Springs, FL

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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
10D2085032Soma Medical Center MD PA #63580 Lake Worth Rd, Lake Worth, FL 33461Certificate of waiverOct 6, 2026

National Provider Directory

National Provider Directory
Tax ID family
Soma Medical Center PA 62 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3580 Lake Worth Rd
Ste 101
Palm Springs, FL 33461

1402 Royal Palm Beach Blvd
Ste 4
Royal Palm Beach, FL 33411

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1399334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650240000000",
    "number": "1295145704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3580 LAKE WORTH RD",
            "city": "PALM SPRINGS",
            "state": "FL",
            "postal_code": "334614029",
            "telephone_number": "561-275-1155",
            "fax_number": "561-275-1156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3580 LAKE WORTH RD",
            "city": "PALM SPRINGS",
            "state": "FL",
            "postal_code": "334614029",
            "telephone_number": "561-275-1155",
            "fax_number": "561-275-1156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOMA MEDICAL CENTER PA 6",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-06",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A",
        "authorized_official_last_name": "NUNEZ",
        "authorized_official_first_name": "RAFAEL",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "561-275-1155",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "ME0076971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "255695200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOMA MEDICAL CENTER PA 6",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SOMA MEDICAL CENTER PA 6",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Palm Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.