Organization Active NPI

Pediatric Partners of Palm Beach County

  • Psychologist
  • Palm Beach Gardens, FL
National Provider Identifier
1619577798
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
PEDIATRIC PARTNERS OF PALM BEACH COUNTY
Practice address
3401 Pga Blvd Ste 300
Palm Beach Gardens, FL 33410-2824
Phone
(561) 741-0000
NPI assigned
Oct 28, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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

Authorized official

Name
Bethany Lacroix
Title
Revenue Cycle Supervisor
Phone
(561) 510-2356

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

3401 Pga Blvd Ste 300
Palm Beach Gardens, FL 33410-2824

Mailing address

3401 Pga Blvd Ste 300
Palm Beach Gardens, FL 33410-2824

Other identifiers 1

IdentifierTypeStateIssuer
108433100MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Pediatric Partners of Palm Beach County3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3401 Pga Blvd
Ste 300
Palm Beach Gardens, FL 33410
Phone (561) 741-0000

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": "1603843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603843200000",
    "number": "1619577798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 PGA BLVD STE 300",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334102824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 PGA BLVD STE 300",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334102824",
            "telephone_number": "561-741-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC PARTNERS OF PALM BEACH COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-28",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A",
        "authorized_official_last_name": "LACROIX",
        "authorized_official_first_name": "BETHANY",
        "authorized_official_title_or_position": "REVENUE CYCLE SUPERVISOR",
        "authorized_official_telephone_number": "561-510-2356"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "108433100",
            "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 Oct 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.