Active NPI
Abacoa Medical Supplies Inc
- Durable Medical Equipment & Medical Supplies
- Boca Raton, FL
National Provider Identifier
1619465689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- License
- 2018106632
- Legal business name
- ABACOA MEDICAL SUPPLIES INC
- Doing business as
- Abacoa Medical Supplies, Inc.
- Practice address
- 3100 NW Boca Raton Blvd Ste 213
Boca Raton, FL 33431-6658 - Phone
- (561) 994-2302
- Fax
- (888) 204-4514
- NPI assigned
- Apr 25, 2018
- Last updated
- May 15, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lawrence A Dickson
- Title
- President
- Phone
- (561) 994-2302
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | NU | ||
| Durable Medical Equipment & Medical Supplies | 332B00000X | 2018106632 | FL | Primary |
Addresses
Primary practice location
3100 NW Boca Raton Blvd Ste 213
Boca Raton, FL 33431-6658
Mailing address
3100 NW Boca Raton Blvd Ste 213
Boca Raton, FL 33431-6658
Phone (561) 994-2302
Other identifiers 36
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0393111 | Medicaid | OH | |
| 30004619230001 | Medicaid | KS | |
| 5737727 | Other | NCPDP | |
| DM1616 | Medicaid | SC | |
| 1036577000001 | Medicaid | PA | |
| 151768600 | Medicaid | WY | |
| 500758565 | Medicaid | OR | |
| 620065893 | Medicaid | MO | |
| 6710681 | Medicaid | VT | |
| 7100570080 | Medicaid | KY | |
| Q047492 | Medicaid | TN | |
| 006887 | Medicaid | HI | |
| 0698636 | Medicaid | NJ | |
| 200806460A | Medicaid | OK | |
| 2483871 | Medicaid | LA | |
| 282023400 | Medicaid | MD | |
| 300019499 | Medicaid | IN | |
| 396703601 | Medicaid | TX | |
| 900017037 | Medicaid | CO | |
| 003227252A | Medicaid | GA | |
| 234796741 | Medicaid | AR | |
| 53407334 | Medicaid | NM | |
| 100092814 | Medicaid | WI | |
| 10026761200 | Medicaid | NE | |
| 2124621 | Medicaid | WA | |
| 2177429 | Other | PK | |
| 3002474 | Medicaid | SD | |
| 1480327 | Medicaid | ND | |
| 250572523 | Medicaid | DE | |
| 006058509 | Medicaid | MS | |
| 067848214 | Medicaid | DC | |
| 101491800 | Medicaid | FL | |
| 225119 | Medicaid | AL | |
| 435148 | Medicaid | AZ | |
| 937133 | Medicaid | CA | |
| NPC-0004670 | Other | OR | BOARD OF PHARMACY |
Other names 1
- Abacoa Medical Supplies, Inc.
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | medicaid@abacoamedical.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180815002729 | FL | DME Supplier - Medical Supply Company | 9133478787 | Practice locations: Boca Raton, FL |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Abacoa Medical Supplies, Inc | Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Insulin Infusion Pumps and/or Supplies|Ostomy Supplies|Urological Supplies | Accepts assignment |
National Provider Directory
National Provider DirectoryLocations
3100 NW 2nd Ave
Ste 213
Boca Raton, FL 33431
Phone (561) 994-2302
751 Park of Commerce Dr
Ste 138
Boca Raton, FL 33487
Phone (561) 994-2302
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
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"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3100 NW BOCA RATON BLVD STE 213",
"city": "BOCA RATON",
"state": "FL",
"postal_code": "334316658",
"telephone_number": "561-994-2302",
"fax_number": "888-204-4514"
},
{
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}
],
"practiceLocations": [],
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"organizational_subpart": "NO",
"enumeration_date": "2018-04-25",
"last_updated": "2024-05-15",
"certification_date": "2024-05-15",
"status": "A",
"authorized_official_last_name": "DICKSON",
"authorized_official_first_name": "LAWRENCE",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "561-994-2302"
},
"taxonomies": [
{
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"taxonomy_group": "",
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"primary": false
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{
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],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "medicaid@abacoamedical.com",
"affiliation": "N",
"endpointDescription": "Secure email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "html",
"address_1": "3100 NW Boca Raton Blvd Ste 213",
"city": "Boca Raton",
"state": "FL",
"country_code": "US",
"postal_code": "334316658",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "Abacoa Medical Supplies, Inc.",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Boca Raton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; 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.