Individual provider Active NPI

Bruce DM White, MSPT

  • Physical Therapist
  • Royal Palm Beach, FL
National Provider Identifier
1366541773
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT14615 Issued in FL
Practice address
11440 Okeechobee Blvd Ste 103
Royal Palm Beach, FL 33411-8707
Phone
(561) 792-9859
Fax
(561) 792-8521
NPI assigned
Sep 22, 2006
Last updated
Jun 26, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT14615 FL Primary

Addresses

Primary practice location

11440 Okeechobee Blvd Ste 103
Royal Palm Beach, FL 33411-8707

Mailing address

5840 Corporate Way Ste A11
West Palm Beach, FL 33407-2048
Phone (561) 432-0111

Other identifiers 3

IdentifierTypeStateIssuer
891435400MedicaidFL
11366904OtherFLCAQH
822053OtherFLACN GROUP

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050719000363 FL Practitioner - Physical Therapist in Private Practice 3274513676 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10131 Forest Hill Blvd
Wellington, FL 33414-6109
Phone (561) 803-8616

10131 W Forest Hill Blvd
Wellington, FL 33414-6109
Phone (561) 798-6600

440 N State Rd
Royal Palm Beach, FL 33411-3504
Phone (561) 798-6600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Care Medical Center LLC CurrentSince Dec 19, 2013 Accepting new patients
Center for Bone & Joint Surgery of the Palm Beaches, P.a. Past Accepting new patients
Intergold LLC PastSince Feb 1, 2007 Accepting new patients

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": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1366541773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5840 CORPORATE WAY STE A11",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334072048",
            "telephone_number": "561-432-0111",
            "fax_number": "561-432-1075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11440 OKEECHOBEE BLVD STE 103",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "334118707",
            "telephone_number": "561-792-9859",
            "fax_number": "561-792-8521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "BRUCE",
        "middle_name": "DM",
        "name_prefix": "Mr.",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT14615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891435400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11366904",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN GROUP",
            "identifier": "822053",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; 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.