Individual provider Active NPI

Paulette Gopman Perlowin, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Hollywood, FL
National Provider Identifier
1639230899
Registry record updated Jun 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
ARNP 2053552 Issued in FL
Practice address
3400 N 29TH Ave
Hollywood, FL 33020
Phone
(954) 276-3404
Fax
(954) 965-6444
NPI assigned
Dec 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X ARNP 2053552 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X ARNP 2053552 FL Primary

Addresses

Primary practice location

3400 N 29TH Ave
Hollywood, FL 33020

Mailing address

2900 Corporate Way
Door D
Miramar, FL 33025-3925
Phone (954) 276-5685

Other practice location 1

4291 NW 1st Dr
Deerfield Beach, FL 33442-9245
Phone (954) 471-2801

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070828000024 FL Practitioner - Nurse Practitioner 5193817757 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chrysalis Center, Inc. 36 clinicians

Practice addresses (Care Compare)

3800 W Broward Blvd
Suite 100
Fort Lauderdale, FL 33312-1018
Phone (954) 587-1008

4291 NW 1St Dr
Deerfield Beach, FL 33442-9245
Phone (954) 471-2801

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ARNP 2053552FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Broward Hospital District CurrentSince Jul 1, 2018 Accepting new patients
Chrysalis Center, LLC CurrentSince Apr 2, 2021 Accepting new patients
South Broward Hospital District CurrentSince Jul 1, 2018 Accepting new patients
South Broward Hospital District Current Accepting new patients
Chrysalis Center Inc Past Accepting new patients
Chrysalis Center, LLC Past Accepting new patients

Locations

3800 W Broward Blvd
Ste 100
Ft Lauderdale, FL 33312

3400 N 29th Ave
Hollywood, FL 33020
Phone (954) 276-3400

2900 Corporate Way
#D
Miramar, FL 33025
Phone (954) 276-5581

3501 Johnson St
Pembroke Park, FL 33021
Phone (954) 265-2000

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530230400000",
    "number": "1639230899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 CORPORATE WAY",
            "address_2": "DOOR D",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330253925",
            "telephone_number": "954-276-5685",
            "fax_number": "954-985-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 N 29TH AVE",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "33020",
            "telephone_number": "954-276-3404",
            "fax_number": "954-965-6444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4291 NW 1st Dr",
            "address_purpose": "LOCATION",
            "city": "Deerfield Beach",
            "state": "FL",
            "postal_code": "334429245",
            "country_code": "US",
            "telephone_number": "954-471-2801",
            "fax_number": "954-531-1708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERLOWIN",
        "first_name": "PAULETTE",
        "middle_name": "GOPMAN",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2018-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP 2053552",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "ARNP 2053552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.