Organization Active NPI

University Internal Medicine of Palm Beach LLC

  • Internal Medicine Physician
  • Boynton Beach, FL
National Provider Identifier
1639189392
Registry record updated May 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
UNIVERSITY INTERNAL MEDICINE OF PALM BEACH LLC
Practice address
10151 Enterprise Center Blvd
Suite 202
Boynton Beach, FL 33437-3759
Phone
(561) 374-8811
Fax
(561) 374-8822
NPI assigned
Aug 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2011

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

Authorized official

Name
Dr. Sonny Van Nguyen, M.D.NPI 1861402505
Title
Manager
Phone
(561) 374-8811

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

10151 Enterprise Center Blvd
Suite 202
Boynton Beach, FL 33437-3759

Mailing address

PO Box 480456
Delray Beach, FL 33448-0456
Phone (561) 374-8811

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041204000206 FL Part B Supplier - Clinic/Group Practice 8921064643 Receives reassigned benefits from 1 practitioner
Practice locations: Boynton Beach, FL

National Provider Directory

National Provider Directory

Locations

10151 Entrprs Cntr Blvd
Ste 202
Boynton Beach, FL 33437
Phone (561) 374-8811

10301 Hagen Ranch Rd
Ste 750
Boynton Beach, FL 33437
Phone (561) 512-4924

10151 Enterprise Ctr
Ste 2
Boynton Beach, FL 33437
Phone (561) 374-8811

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": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305072000000",
    "number": "1639189392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 480456",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334480456",
            "telephone_number": "561-374-8811",
            "fax_number": "561-374-8822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10151 ENTERPRISE CENTER BLVD",
            "address_2": "SUITE 202",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334373759",
            "telephone_number": "561-374-8811",
            "fax_number": "561-374-8822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY INTERNAL MEDICINE OF PALM BEACH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-08",
        "last_updated": "2011-05-11",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "SONNY",
        "authorized_official_middle_name": "VAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "561-374-8811",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.