Organization Active NPI

Richard M. Dwoskin, M.D., P.a.

  • Gastroenterology Physician
  • Palm Beach Gardens, FL
National Provider Identifier
1508159427
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
RICHARD M. DWOSKIN, M.D., P.A.
Practice address
3370 Burns Rd Ste 105a
Palm Beach Gardens, FL 33410-4327
Phone
(561) 775-1506
NPI assigned
May 25, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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

Authorized official

Name
Richard Mark Dwoskin, M.D.NPI 1609841717
Title
President
Phone
(561) 775-1506

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
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

3370 Burns Rd Ste 105a
Palm Beach Gardens, FL 33410-4327

Mailing address

12 Wycliff Rd
Palm Beach Gardens, FL 33418-6846

Other identifiers 1

IdentifierTypeStateIssuer
040227300MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110627000115 FL Part B Supplier - Clinic/Group Practice 4385822162 Receives reassigned benefits from 1 practitioner
Practice locations: Palm Beach Gardens, FL

National Provider Directory

National Provider Directory

Locations

3370 Burns Rd
Ste 105A
Palm Beach Gardens, FL 33410
Phone (561) 775-1506

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 1

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": "1306281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661817600000",
    "number": "1508159427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 WYCLIFF RD",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334186846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3370 BURNS RD STE 105A",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334104327",
            "telephone_number": "561-775-1506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD M. DWOSKIN, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-25",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A",
        "authorized_official_last_name": "DWOSKIN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-775-1506",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "040227300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.