NPIMap

Organization Active NPI

Palm Beach Sportsmedicine & Orthopaedic Center PA

  • Orthopaedic Surgery Physician
  • West Palm Beach, FL
National Provider Identifier
1508901570
Registry record updated Apr 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
ME0029407 Issued in FL
Legal business name
PALM BEACH SPORTSMEDICINE & ORTHOPAEDIC CENTER PA
Practice address
4440 Beacon Cir
Suite 100
West Palm Beach, FL 33407-3243
Phone
(561) 845-6000
Fax
(561) 845-6916
NPI assigned
Feb 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2019

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

Authorized official

Name
Ms. Lynne Lerose
Title
Practice Manager
Phone
(561) 845-6000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X ME0029407 FL Primary

Addresses

Primary practice location

4440 Beacon Cir
Suite 100
West Palm Beach, FL 33407-3243

Mailing address

4440 Beacon Cir
Ste 100
West Palm Beach, FL 33407-3243
Phone (561) 845-6000

Other names 1

  • PALM BEACH SPORTSMEDICINE Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050606001088 FL Part B Supplier - Clinic/Group Practice 7012950538 Receives reassigned benefits from 8 practitioners
Practice locations: West Palm BCH, FL
O20100930027738 FL DME Supplier - Physician - Orthopedic/Orthopedic Surgery 7012950538 Practice locations: West Palm Beach, FL

National Provider Directory

National Provider Directory

Locations

641 University Blvd
Ste B214
Jupiter, FL 33458

641 University Blvd
Ste 214
Jupiter, FL 33458

4440 Beacon Cir
Ste 100
West Palm Beach, FL 33407
Phone (561) 845-6000

Practitioners & affiliated clinicians

Practitioners 8

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": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554076800000",
    "number": "1508901570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4440 BEACON CIR",
            "address_2": "STE 100",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334073243",
            "telephone_number": "561-845-6000",
            "fax_number": "561-845-6916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4440 BEACON CIR",
            "address_2": "SUITE 100",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334073243",
            "telephone_number": "561-845-6000",
            "fax_number": "561-845-6916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALM BEACH SPORTSMEDICINE & ORTHOPAEDIC CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2019-04-01",
        "status": "A",
        "authorized_official_last_name": "LEROSE",
        "authorized_official_first_name": "LYNNE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "561-845-6000",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "ME0029407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PALM BEACH SPORTSMEDICINE",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "PALM BEACH SPORTSMEDICINE",
            "code": "5",
            "type": "Other 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 Apr 1, 2019; 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.