NPIMap

Organization Active NPI

Palm Beach Neurosurgery

  • Surgical Physician Assistant
  • Wellington, FL
National Provider Identifier
1477099596
Registry record updated Jan 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA9110078 Issued in FL
Legal business name
PALM BEACH NEUROSURGERY
Practice address
3319 State Road 7
Suite 313
Wellington, FL 33449-8094
Phone
(561) 433-4444
NPI assigned
Jan 12, 2017
Last updated
Jan 12, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2017

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

Authorized official

Name
Ms. Ilana Sprague, PA-C
Title
Physician Assistant
Phone
(248) 505-9648

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AS0400X PA9110078 FL Primary

Addresses

Primary practice location

3319 State Road 7
Suite 313
Wellington, FL 33449-8094

Mailing address

1111 E Sunrise Blvd
Apt #603
Fort Lauderdale, FL 33304-2847
Phone (248) 505-9648

National Provider Directory

National Provider Directory

Locations

3319 S State Road 7
Ste 313
Wellington, FL 33449
Phone (561) 433-4444

Practitioners & affiliated clinicians

Practitioners 21

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.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1484179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484179200000",
    "number": "1477099596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 E SUNRISE BLVD",
            "address_2": "APT #603",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333042847",
            "telephone_number": "248-505-9648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3319 STATE ROAD 7",
            "address_2": "SUITE 313",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334498094",
            "telephone_number": "561-433-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALM BEACH NEUROSURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-12",
        "last_updated": "2017-01-12",
        "status": "A",
        "authorized_official_last_name": "SPRAGUE",
        "authorized_official_first_name": "ILANA",
        "authorized_official_title_or_position": "PHYSICIAN ASSISTANT",
        "authorized_official_telephone_number": "248-505-9648",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9110078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.