NPIMap

Organization Active NPI

Palm Beach Pediatrics, LLC

  • Pediatrics Physician
  • West Palm Beach, FL
National Provider Identifier
1508047952
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PALM BEACH PEDIATRICS, LLC
Practice address
4700 N Congress Ave Ste 201
West Palm Beach, FL 33407-3291
Phone
(561) 509-5009
NPI assigned
Nov 14, 2007
Organization subpart
Yes
Parent organization
PALM BEACH PEDIATRICS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

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

Authorized official

Name
Elizabeth Larsen
Title
Head of Practice Operations
Phone
(319) 936-6898

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

4700 N Congress Ave Ste 201
West Palm Beach, FL 33407-3291

Mailing address

2000 Palm Beach Lakes Blvd Ste 901
West Palm Beach, FL 33409-6506
Phone (561) 509-5009

Other identifiers 2

IdentifierTypeStateIssuer
124121502MedicaidFL
379641801MedicaidFL

Other names 2

  • Bluebird Kids Health Doing business as
  • Palm Beach Pediatrics, PA Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Palm Beach Pediatrics LLC12 organizations share this tax ID, including this one
Part of
Palm Beach Pediatrics LLC

Other organizations with this tax ID 11

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

Locations

5589 Okeechobee Blvd
Ste 201
West Palm Beach, FL 33417

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765411200000",
    "number": "1508047952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 PALM BEACH LAKES BLVD STE 901",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334096506",
            "telephone_number": "561-509-5009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 N CONGRESS AVE STE 201",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334073291",
            "telephone_number": "561-509-5009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALM BEACH PEDIATRICS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PALM BEACH PEDIATRICS, LLC",
        "enumeration_date": "2007-11-14",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A",
        "authorized_official_last_name": "LARSEN",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "HEAD OF PRACTICE OPERATIONS",
        "authorized_official_telephone_number": "319-936-6898"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124121502",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "379641801",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bluebird Kids Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bluebird Kids Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Palm Beach Pediatrics, PA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2025; 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.