NPIMap

Organization Active NPI

Palm Beach Pediatrics, LLC

  • Pediatrics Physician
  • Loxahatchee Groves, FL
National Provider Identifier
1629259072
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PALM BEACH PEDIATRICS, LLC
Practice address
13475 Southern Blvd Ste 202
Loxahatchee Groves, FL 33470-9234
Phone
(561) 509-5009
NPI assigned
Nov 14, 2007
Organization subpart
Yes
Parent organization
PALM BEACH PEDIATRICS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

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

Authorized official

Name
Elizabeth Larsen
Title
Head of Practice Operations
Phone
(319) 936-6898

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103T00000X
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

13475 Southern Blvd Ste 202
Loxahatchee Groves, FL 33470-9234

Mailing address

2000 Palm Beach Lakes Blvd Ste 901
West Palm Beach, FL 33409-6506
Phone (561) 509-5009

Other identifiers 2

IdentifierTypeStateIssuer
379641800MedicaidFL
124121500MedicaidFL

Other names 2

  • Bluebird Kids Health Doing business as
  • Palm Beach Pediatrics, PA Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Palm Beach Pediatrics LLC12 organizations share this tax ID, including this one
Part of
Palm Beach Pediatrics LLC

Other organizations with this tax ID 11

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

Locations

6080 Boynton Beach Blvd
Ste 240
Boynton Beach, FL 33437

13475 Southern Blvd
Ste 202
Loxahatchee Groves, FL 33470
Phone (561) 798-2468

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765411200000",
    "number": "1629259072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 PALM BEACH LAKES BLVD STE 901",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334096506",
            "telephone_number": "561-509-5009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13475 SOUTHERN BLVD STE 202",
            "city": "LOXAHATCHEE GROVES",
            "state": "FL",
            "postal_code": "334709234",
            "telephone_number": "561-509-5009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALM BEACH PEDIATRICS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PALM BEACH PEDIATRICS, LLC",
        "enumeration_date": "2007-11-14",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A",
        "authorized_official_last_name": "LARSEN",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "HEAD OF PRACTICE OPERATIONS",
        "authorized_official_telephone_number": "319-936-6898"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "379641800",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124121500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bluebird Kids Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Palm Beach Pediatrics, PA",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Palm Beach Pediatrics, PA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Loxahatchee Groves, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2025; 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.