Organization Active NPI

Advanced Internal Medicine LLC

  • Internal Medicine Physician
  • Jupiter, FL
National Provider Identifier
1356496137
Registry record updated Jun 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME86718 Issued in FL
Legal business name
ADVANCED INTERNAL MEDICINE LLC
Practice address
601 University Blvd
Suite 105
Jupiter, FL 33458
Phone
(561) 625-9575
Fax
(561) 625-9533
NPI assigned
Jan 24, 2007
Last updated
Jun 20, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2011

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

Authorized official

Name
Dr. Saluja Varghese, MD
Title
Owner
Phone
(561) 625-9575

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME86718 FL Primary
Phlebology Physician 202K00000X ME85291 FL

Addresses

Primary practice location

601 University Blvd
Suite 105
Jupiter, FL 33458

Mailing address

601 University Boulevard
Suite 105
Jupiter, FL 33458
Phone (561) 625-9575

Other identifiers 1

IdentifierTypeStateIssuer
P00083413OtherFLPALMETTO MC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070808000030 FL Part B Supplier - Clinic/Group Practice 3476644311 Receives reassigned benefits from 2 practitioners
Practice locations: Jupiter, FL; Palm Beach Gardens, FL; Wellington, FL

National Provider Directory

National Provider Directory

Locations

3535 Military Trl
Ste 204
Jupiter, FL 33458
Phone (561) 406-6574

601 University Blvd
Ste 105
Jupiter, FL 33458
Phone (561) 625-9575

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308528000000",
    "number": "1356496137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 UNIVERSITY BOULEVARD",
            "address_2": "SUITE 105",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "33458",
            "telephone_number": "561-625-9575",
            "fax_number": "561-625-9533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 UNIVERSITY BLVD",
            "address_2": "SUITE 105",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "33458",
            "telephone_number": "561-625-9575",
            "fax_number": "561-625-9533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED INTERNAL MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2011-06-20",
        "status": "A",
        "authorized_official_last_name": "VARGHESE",
        "authorized_official_first_name": "SALUJA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-625-9575",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME86718",
            "primary": true
        },
        {
            "code": "202K00000X",
            "taxonomy_group": "",
            "desc": "Phlebology",
            "state": "FL",
            "license": "ME85291",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO MC",
            "identifier": "P00083413",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jupiter, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2011; 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.