Israel L. Wacks, M.D., P.a.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

ME0053751 Issued in FL

Legal business name

ISRAEL L. WACKS, M.D., P.A.

Practice address

210 Jupiter Lakes Blvd
Ste 5201
Jupiter, FL 33458-7191

Phone

(561) 743-2450

Fax

(561) 744-7090

NPI assigned

Dec 9, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Israel Louis Wacks, M.D.NPI 1437272895

Title

President

Phone

(561) 743-2450

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Israel Louis Wacks, M.D.

  • Nephrology Physician
  • Jupiter, FL
  • NPI 1437272895
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1291852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481587200000",
    "number": "1366745523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 221311",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334221311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 JUPITER LAKES BLVD",
            "address_2": "STE 5201",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334587191",
            "telephone_number": "561-743-2450",
            "fax_number": "561-744-7090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISRAEL L. WACKS, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-09",
        "last_updated": "2016-12-13",
        "status": "A",
        "authorized_official_last_name": "WACKS",
        "authorized_official_first_name": "ISRAEL",
        "authorized_official_middle_name": "LOUIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-743-2450",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME0053751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nephrology Physician in Jupiter, FL
• Providers in Jupiter, FL by specialty
• Nephrology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2016; 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.