Individual provider Active NPI

Michael A Ravitsky, DO

  • Cardiovascular Disease Physician
  • West Palm Beach, FL
National Provider Identifier
1578502399
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
OS0003855 Issued in FL
Practice address
4700 N Congress Ave Ste 103
West Palm Beach, FL 33407
Phone
(561) 255-3131
Fax
(855) 346-3451
NPI assigned
Jun 6, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X OS0003855 FL Primary

Addresses

Primary practice location

4700 N Congress Ave Ste 103
West Palm Beach, FL 33407

Mailing address

1094 Military TRL
Jupiter, FL 33458-7021
Phone (561) 255-3131

Other practice location 1

1094 Military Trl
Jupiter, FL 33458-7021
Phone (561) 622-6111

Other identifiers 4

IdentifierTypeStateIssuer
037709100MedicaidFL
060013128OtherFLRR MEDICARE
064516800OtherFLGRP
050003855OtherFLMED LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110601000404 FL Practitioner - Cardiovascular Disease (Cardiology) 7012194988 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS0003855FLMDCardiovascular Disease Physician
3855FLMDSurgical Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Stuart Cardiology Group LLC Cardiovascular Disease CurrentSince Apr 10, 2023 Accepting new patients
The Medical Group of South Florida, Inc Past Accepting new patients
Gardens Ekg Associates Cardiovascular Disease Past Accepting new patients
The Medical Group of South Florida Inc PastSince Oct 17, 2021 Accepting new patients

Locations

11380 SW Village Pkwy
Ste 300
Port St Lucie, FL 34987

1001 SE Monterey Commons Blvd
Ste 300
Stuart, FL 34996
Phone (561) 286-9400

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1578502399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1094 MILITARY TRL",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334587021",
            "telephone_number": "561-255-3131",
            "fax_number": "855-215-9930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 N CONGRESS AVE STE 103",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "33407",
            "telephone_number": "561-255-3131",
            "fax_number": "855-346-3451"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1094 Military Trl",
            "address_purpose": "LOCATION",
            "city": "Jupiter",
            "state": "FL",
            "postal_code": "334587021",
            "country_code": "US",
            "telephone_number": "561-622-6111",
            "fax_number": "855-215-9930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAVITSKY",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "OS0003855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "037709100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "060013128",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GRP",
            "identifier": "064516800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MED LICENSE",
            "identifier": "050003855",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.