Individual provider Active NPI

Betsy Jo Pearl, LCSW

  • Clinical Social Worker
  • Boynton Beach, FL
National Provider Identifier
1316179542
Registry record updated Apr 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4374 Issued in FL
Practice address
5837 Northpointe LN
Boynton Beach, FL 33437-2008
Phone
(561) 632-5656
NPI assigned
Aug 21, 2009
Last updated
Apr 27, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 4374 FL Primary

Addresses

Primary practice location

5837 Northpointe LN
Boynton Beach, FL 33437-2008

Mailing address

5837 Northpointe LN
Boynton Beach, FL 33437-2008
Phone (561) 632-5656

Other identifiers 1

IdentifierTypeStateIssuer
201966531OtherFLTAX ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110916000128 FL Practitioner - Clinical Social Worker 3779754049 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Boca Raton Psychiatry, LLCGroup PAC ID 0749547750, 27 clinicians

Practice addresses (Care Compare)

9980 N Central Park Blvd
Suite 210
Boca Raton, FL 33428-1703
Phone (561) 342-8822

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4374FLMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Boca Raton Psychiatry, LLC CurrentSince Feb 1, 2022 Accepting new patients
Different Like Me Inc Clinical Past Accepting new patients
JFK Internal Medicine Faculty Practice, LLC Past Accepting new patients

Locations

9980 Central Park Blvd N
Ste 210
Boca Raton, FL 33428
Phone (561) 342-8822

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1250812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303862400000",
    "number": "1316179542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5837 NORTHPOINTE LN",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334372008",
            "telephone_number": "561-632-5656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5837 NORTHPOINTE LN",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334372008",
            "telephone_number": "561-632-5656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARL",
        "first_name": "BETSY",
        "middle_name": "JO",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-21",
        "last_updated": "2011-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "4374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "201966531",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

Verify at the official NPI Registry.