Organization Active NPI

Boca Raton Center for Internal Medicine PLLC

  • Internal Medicine Physician
  • Boca Raton, FL
National Provider Identifier
1306347794
Registry record updated Sep 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME117449 Issued in FL
Legal business name
BOCA RATON CENTER FOR INTERNAL MEDICINE PLLC
Practice address
880 NW 13TH St Ste 120
Boca Raton, FL 33486-2342
Phone
(561) 408-8195
Fax
(561) 293-8348
NPI assigned
Feb 22, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2018

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

Authorized official

Name
Dr. Tiago Miguel, MD
Title
Physician
Phone
(561) 408-8195

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X ME117449 FL Primary

Addresses

Primary practice location

880 NW 13TH St Ste 120
Boca Raton, FL 33486-2342

Mailing address

880 NW 13TH St Ste 120
Boca Raton, FL 33486-2342
Phone (561) 408-8195

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180921000587 FL Part B Supplier - Clinic/Group Practice 9537410089 Receives reassigned benefits from 1 practitioner
Practice locations: Boca Raton, FL

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
10D2144387Boca Raton Center for Internal Medicine, the880 NW 13TH St Ste 120, Boca Raton, FL 33486Certificate of waiverFeb 14, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1519257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536537600000",
    "number": "1306347794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 NW 13TH ST STE 120",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334862342",
            "telephone_number": "561-408-8195",
            "fax_number": "561-293-8348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 NW 13TH ST STE 120",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334862342",
            "telephone_number": "561-408-8195",
            "fax_number": "561-293-8348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOCA RATON CENTER FOR INTERNAL MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-22",
        "last_updated": "2018-09-10",
        "status": "A",
        "authorized_official_last_name": "MIGUEL",
        "authorized_official_first_name": "TIAGO",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "561-408-8195",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME117449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2018; 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.