Organization Active NPI

Informed Improvement Inc

  • Psychiatry Physician
  • Sunny Isles Beach, FL
National Provider Identifier
1417643412
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
INFORMED IMPROVEMENT INC
Practice address
17100 Collins Ave Ste 216
Sunny Isles Beach, FL 33160-3675
Phone
(305) 945-9595
NPI assigned
Apr 12, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Authorized official

Name
Dr. Nikita Bodoukhin, MDNPI 1477013639
Title
President
Phone
(305) 945-9595

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
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

17100 Collins Ave Ste 216
Sunny Isles Beach, FL 33160-3675

Mailing address

17100 Collins Ave Ste 216
Sunny Isles Beach, FL 33160-3675
Phone (305) 945-9595

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240124003486 FL Part B Supplier - Clinic/Group Practice 0042663213 Receives reassigned benefits from 1 practitioner
Practice locations: Sunny Isles Beach, FL

National Provider Directory

National Provider Directory

Locations

17100 Collins Ave
Ste 216
Sunny Isles Beach, FL 33160
Phone (305) 204-5665

Practitioners & affiliated clinicians

Practitioners 3

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": "1681257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681257600000",
    "number": "1417643412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17100 COLLINS AVE STE 216",
            "city": "SUNNY ISLES BEACH",
            "state": "FL",
            "postal_code": "331603675",
            "telephone_number": "305-945-9595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17100 COLLINS AVE STE 216",
            "city": "SUNNY ISLES BEACH",
            "state": "FL",
            "postal_code": "331603675",
            "telephone_number": "305-945-9595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFORMED IMPROVEMENT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-12",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A",
        "authorized_official_last_name": "BODOUKHIN",
        "authorized_official_first_name": "NIKITA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-945-9595",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunny Isles Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2023; 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.