NPIMap

Organization Active NPI

Jupiter West Medical Center, Inc

  • Physical Therapist
  • Port St Lucie, FL
National Provider Identifier
1497415053
Registry record updated Aug 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
JUPITER WEST MEDICAL CENTER, INC
Practice address
10377 S US Highway 1 Ste 101
Port St Lucie, FL 34952-5630
Phone
(772) 337-1300
Fax
(800) 783-5176
NPI assigned
Dec 23, 2021
Last updated
Aug 18, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2022

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

Authorized official

Name
Elaine Oswald, RN
Title
Credentialing Specialist
Phone
(561) 236-3741

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

10377 S US Highway 1 Ste 101
Port St Lucie, FL 34952-5630

Mailing address

2632 W Indiantown Rd
Jupiter, FL 33458-5889
Phone (561) 744-7373

Other identifiers 1

IdentifierTypeStateIssuer
000647406MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080805000566 FL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5193759371 Receives reassigned benefits from 2 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jupiter, FL; Lake Worth, FL; Palm Beach Gardens, FL; Port St Lucie, FL

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Jupiter West Medical Center Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

672 SW Prima Vista Blvd
Ste 202
Port St Lucie, FL 34983
Phone (561) 744-7373

8942 S US Highway 1
Port St Lucie, FL 34952
Phone (561) 335-8373

9109 S US Highway 1
Ste 102
Port St Lucie, FL 34952
Phone (772) 253-1642

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": "1640217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660780800000",
    "number": "1497415053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2632 W INDIANTOWN RD",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334585889",
            "telephone_number": "561-744-7373",
            "fax_number": "800-783-5176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10377 S US HIGHWAY 1 STE 101",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349525630",
            "telephone_number": "772-337-1300",
            "fax_number": "800-783-5176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUPITER WEST MEDICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-23",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A",
        "authorized_official_last_name": "OSWALD",
        "authorized_official_first_name": "ELAINE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "561-236-3741",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000647406",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Aug 18, 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.