NPIMap

Organization Active NPI

Rodolfo Carrillo Jimenez MD PA

Doing business as Florida Premier Cardiology

  • Interventional Cardiology Physician
  • Delray Beach, FL
National Provider Identifier
1477714533
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
Legal business name
RODOLFO CARRILLO JIMENEZ MD PA
Doing business as
Florida Premier Cardiology
Practice address
5210 Linton Blvd Ste 301
Delray Beach, FL 33484-6537
Phone
(561) 496-7900
Fax
(877) 536-5811
NPI assigned
Jun 21, 2008
Last updated
Mar 2, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

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

Authorized official

Name
Rodolfo Carrillo Jimenez, MDNPI 1871513754
Title
President
Phone
(561) 496-7900

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
Interventional Cardiology Physician 207RI0011X NU Primary

Addresses

Primary practice location

5210 Linton Blvd Ste 301
Delray Beach, FL 33484-6537

Mailing address

5210 Linton Blvd Ste 301
Delray Beach, FL 33484-6537
Phone (561) 496-7900

Other identifiers 1

IdentifierTypeStateIssuer
264560200MedicaidFL

Other names 1

  • Florida Premier Cardiology Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081117000424 FL Part B Supplier - Clinic/Group Practice 5395805600 Receives reassigned benefits from 8 practitioners
Practice locations: Delray Beach, FL

National Provider Directory

National Provider Directory

Locations

10151 Entrprs Cntr Blvd
Ste 103
Boynton Beach, FL 33437
Phone (561) 733-0379

11195 S Jog Rd
Ste 6
Boynton Beach, FL 33437
Phone (561) 404-0697

8188 S Jog Rd
Ste 100
Boynton Beach, FL 33472
Phone (561) 572-2237

8190 S Jog Rd
Ste 105
Boynton Beach, FL 33472
Phone (561) 369-3669

5210 Linton Blvd
Ste 301
Delray Beach, FL 33484
Phone (561) 496-7900

Networks

  • HealthSun Health Plans Network

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BADGCD

Practitioners & affiliated clinicians

Practitioners 8

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": "1214006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646179200000",
    "number": "1477714533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5210 LINTON BLVD STE 301",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334846537",
            "telephone_number": "561-496-7900",
            "fax_number": "775-365-8118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5210 LINTON BLVD STE 301",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334846537",
            "telephone_number": "561-496-7900",
            "fax_number": "877-536-5811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RODOLFO CARRILLO JIMENEZ MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-21",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A",
        "authorized_official_last_name": "CARRILLO JIMENEZ",
        "authorized_official_first_name": "RODOLFO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-496-7900",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "264560200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Florida Premier Cardiology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Florida Premier Cardiology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Delray Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; 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.