NPIMap

Organization Active NPI

Treasure Coast Medical Management, LLC

  • Specialist
  • Port St Lucie, FL
National Provider Identifier
1477844355
Registry record updated Feb 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME43949 Issued in FL
Legal business name
TREASURE COAST MEDICAL MANAGEMENT, LLC
Practice address
1700 SE Hillmoor Dr
Suite 305
Port St Lucie, FL 34952-7539
Phone
(772) 335-5001
Fax
(888) 380-8595
NPI assigned
Apr 26, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2012

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

Authorized official

Name
Jeff Greenberg
Title
Ceo
Phone
(772) 349-0429

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X ME43949 FL Primary

Addresses

Primary practice location

1700 SE Hillmoor Dr
Suite 305
Port St Lucie, FL 34952-7539

Mailing address

1700 SE Hillmoor Dr
Suite 305
Port St Lucie, FL 34952-7539
Phone (772) 335-5001

Other identifiers 1

IdentifierTypeStateIssuer
069125900MedicaidFL

Other names 1

  • AA Medical Management & Billing, LLC Former legal business name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1303776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330128000000",
    "number": "1477844355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 SE HILLMOOR DR",
            "address_2": "SUITE 305",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527539",
            "telephone_number": "772-335-5001",
            "fax_number": "888-380-8595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 SE HILLMOOR DR",
            "address_2": "SUITE 305",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527539",
            "telephone_number": "772-335-5001",
            "fax_number": "888-380-8595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TREASURE COAST MEDICAL MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-26",
        "last_updated": "2012-02-25",
        "status": "A",
        "authorized_official_last_name": "GREENBERG",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "772-349-0429"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME43949",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "069125900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AA Medical Management & Billing, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2012; 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.