Individual provider Active NPI

Ellen Chase Van Mol, M.D.

  • Internal Medicine Physician
  • West Palm Beach, FL
National Provider Identifier
1396975009
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME112566 Issued in FL
Practice address
1000 N Olive Ave
West Palm Beach, FL 33401-3512
Phone
(561) 557-1767
Fax
(561) 327-5125
NPI assigned
Jul 16, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME112566 FL Primary

Addresses

Primary practice location

1000 N Olive Ave
West Palm Beach, FL 33401-3512

Mailing address

9914 Equus Circle
Boynton Beach, FL 60611-5359
Phone (706) 296-6555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120904000174 FL Practitioner - Internal Medicine 7315194933 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME112566FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Florida Hospitalists Inc CurrentSince Sep 1, 2012 Accepting new patients
West Palm Beach Physician Group Inc CurrentSince Nov 1, 2015 Accepting new patients
Florida Hospital Medicine Services, LLC. CurrentSince Nov 1, 2022 Accepting new patients
Serinus Health Inc PastSince Feb 10, 2023 Accepting new patients

Locations

800 Meadows Rd
Boca Raton, FL 33486
Phone (561) 395-7100

9655 Boynton Beach Blvd
Boynton Beach, FL 33472
Phone (561) 336-7000

5352 Linton Blvd
Delray Beach, FL 33484
Phone (561) 495-3166

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

1309 N Flagler Dr
West Palm Beach, FL 33401
Phone (561) 650-6309

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1247702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1396975009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9914 EQUUS CIRCLE",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "606115359",
            "telephone_number": "706-296-6555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N OLIVE AVE",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334013512",
            "telephone_number": "561-557-1767",
            "fax_number": "561-327-5125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN MOL",
        "first_name": "ELLEN",
        "middle_name": "CHASE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-16",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME112566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.