NPIMap

Organization Active NPI

Jupiter Familyhealthcare,PA

  • Family Medicine Physician
  • Jupiter, FL
National Provider Identifier
1366503203
Registry record updated Nov 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME0076350 Issued in FL
Legal business name
JUPITER FAMILYHEALTHCARE,PA
Practice address
4600 Military TRL
#115
Jupiter, FL 33458-4810
Phone
(561) 776-5252
Fax
(561) 776-5255
NPI assigned
Dec 13, 2006
Last updated
Nov 19, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2018

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

Authorized official

Name
Richard Anthony Delucia, MDNPI 1003835604
Title
Ceo
Phone
(561) 776-5252

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 Physician 207Q00000X ME0076350 FL Primary

Addresses

Primary practice location

4600 Military TRL
#115
Jupiter, FL 33458-4810

Mailing address

4600 Military TRL
#115
Jupiter, FL 33458-4810
Phone (561) 776-5252

Other names 1

  • Jupiter Family Healthcare,PA Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050331000145 FL Part B Supplier - Clinic/Group Practice 4587611793 Receives reassigned benefits from 10 practitioners
Practice locations: Jupiter, 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
10D2000041Jupiter Family Healthcare, PA4600 Military TRL Ste 115, Jupiter, FL 33458Certificate of waiverNov 17, 2027

National Provider Directory

National Provider Directory

Locations

1002 S Old Dixie Hwy
Ste 306
Jupiter, FL 33458
Phone (561) 743-0005

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BDDIBA

Practitioners & affiliated clinicians

Practitioners 12

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": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542585600000",
    "number": "1366503203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 MILITARY TRL",
            "address_2": "#115",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334584810",
            "telephone_number": "561-776-5252",
            "fax_number": "561-776-5255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 MILITARY TRL",
            "address_2": "#115",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334584810",
            "telephone_number": "561-776-5252",
            "fax_number": "561-776-5255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUPITER FAMILYHEALTHCARE,PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2018-11-19",
        "status": "A",
        "authorized_official_last_name": "DELUCIA",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "561-776-5252",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME0076350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jupiter Family Healthcare,PA",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Jupiter Family Healthcare,PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Nov 19, 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.