Organization Active NPI

Boca Raton Dermatology, P.a.

  • Dermatology Physician
  • Delray Beach, FL
National Provider Identifier
1548308141
Registry record updated Jun 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
ME78255 Issued in FL
Legal business name
BOCA RATON DERMATOLOGY, P.A.
Practice address
5258 Linton Blvd
Suite 306
Delray Beach, FL 33484-6540
Phone
(561) 498-2911
Fax
(561) 496-0282
NPI assigned
Feb 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2010

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

Authorized official

Name
Dr. Howard Adam Bueller, M.D.NPI 1306939814
Title
President
Phone
(561) 498-2911

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
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X ME78255 FL Primary

Addresses

Primary practice location

5258 Linton Blvd
Suite 306
Delray Beach, FL 33484-6540

Mailing address

5258 Linton Blvd
Suite 306
Delray Beach, FL 33484-6540
Phone (561) 498-2911

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040909001389 FL Part B Supplier - Clinic/Group Practice 4284600255 Receives reassigned benefits from 1 practitioner
Practice locations: Delray Beach, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0990498Boca Raton Dermatology PA5258 Linton Blvd Ste 306, Delray Beach, FL 33484ComplianceOct 8, 2027

National Provider Directory

National Provider Directory

Locations

951 NW 13th St
Ste 4C
Boca Raton, FL 33486
Phone (561) 395-0455

5258 Linton Blvd
Ste 306
Delray Beach, FL 33484
Phone (561) 395-0700

Interoperability endpoints

  • FHIR API: https://brderm.mmi.prod.fhir.ema-api.com/fhir/r4/

Practitioners & affiliated clinicians

Practitioners 3

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": "1170460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277856000000",
    "number": "1548308141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5258 LINTON BLVD",
            "address_2": "SUITE 306",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334846540",
            "telephone_number": "561-498-2911",
            "fax_number": "561-496-0282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5258 LINTON BLVD",
            "address_2": "SUITE 306",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334846540",
            "telephone_number": "561-498-2911",
            "fax_number": "561-496-0282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOCA RATON DERMATOLOGY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-03",
        "last_updated": "2010-06-30",
        "status": "A",
        "authorized_official_last_name": "BUELLER",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_middle_name": "ADAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-498-2911",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME78255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delray Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.