Organization Active NPI

Elite Hospitalists, LLC

  • Hospitalist Physician
  • Port St Lucie, FL
National Provider Identifier
1346754058
Registry record updated Mar 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
OS7680 Issued in FL
Legal business name
ELITE HOSPITALISTS, LLC
Practice address
579 NW Lake Whitney Place
101
Port St Lucie, FL 34986-1622
Phone
(772) 249-0260
Fax
(772) 249-0137
NPI assigned
Nov 17, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2022

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

Authorized official

Name
Michael Blum, DONPI 1922082965
Title
Owner
Phone
(772) 249-0260

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
Hospitalist PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208M00000X OS7680 FL Primary

Addresses

Primary practice location

579 NW Lake Whitney Place
101
Port St Lucie, FL 34986-1622

Mailing address

579 NW Lake Whitney Place
101
Port St Lucie, FL 34986-1622
Phone (772) 249-0260

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180117000145 FL Part B Supplier - Clinic/Group Practice 0840559076 Receives reassigned benefits from 5 practitioners
Practice locations: Port St Lucie, FL

National Provider Directory

National Provider Directory

Locations

579 NW Lake Whitney Pl
Ste 101
Port St Lucie, FL 34986
Phone (772) 203-9356

Practitioners & affiliated clinicians

Practitioners 5

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": "1510876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647302400000",
    "number": "1346754058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "579 NW LAKE WHITNEY PLACE",
            "address_2": "101",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349861622",
            "telephone_number": "772-249-0260",
            "fax_number": "772-249-0137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "579 NW LAKE WHITNEY PLACE",
            "address_2": "101",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349861622",
            "telephone_number": "772-249-0260",
            "fax_number": "772-249-0137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE HOSPITALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-17",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A",
        "authorized_official_last_name": "BLUM",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-249-0260",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "OS7680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2022; 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.