Organization Active NPI

South Palm Primary Care LLC

  • Family Medicine Physician
  • Boca Raton, FL
National Provider Identifier
1306413455
Registry record updated Mar 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SOUTH PALM PRIMARY CARE LLC
Practice address
670 Glades Rd Ste 110
Boca Raton, FL 33431-6462
Phone
(561) 361-3133
Fax
(561) 361-9695
NPI assigned
Jun 8, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2026

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

Authorized official

Name
Joann Yi, MDNPI 1477783918
Title
Owner
Phone
(561) 361-3133

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

670 Glades Rd Ste 110
Boca Raton, FL 33431-6462

Mailing address

670 Glades Rd Ste 110
Boca Raton, FL 33431-6462
Phone (561) 361-3133

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220416000088 FL Part B Supplier - Clinic/Group Practice 6608262878 Receives reassigned benefits from 2 practitioners
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
10D2257549South Palm Primary Care LLC670 Glades Rd #110, Boca Raton, FL 33431Certificate of waiverApr 6, 2028

National Provider Directory

National Provider Directory

Locations

660 Glades Rd
Ste 310
Boca Raton, FL 33431
Phone (561) 361-3133

670 Glades Rd
Ste 110
Boca Raton, FL 33431
Phone (561) 289-9467

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": "1623110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774310400000",
    "number": "1306413455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 GLADES RD STE 110",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316462",
            "telephone_number": "561-361-3133",
            "fax_number": "561-361-9695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 GLADES RD STE 110",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316462",
            "telephone_number": "561-361-3133",
            "fax_number": "561-361-9695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH PALM PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-08",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A",
        "authorized_official_last_name": "YI",
        "authorized_official_first_name": "JOANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-361-3133",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "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 Mar 24, 2026; 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.