Organization Active NPI

Dermatology Associates of the Palm Beaches PLLC

  • Dermatology Physician
  • West Palm Beach, FL
National Provider Identifier
1649260308
Registry record updated Apr 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
DERMATOLOGY ASSOCIATES OF THE PALM BEACHES PLLC
Practice address
120A Butler St
West Palm Beach, FL 33407
Phone
(561) 659-1510
Fax
(561) 659-0495
NPI assigned
Oct 25, 2005
Last updated
Apr 17, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2014

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

Authorized official

Name
Dr. Howard Alen Green, MDNPI 1053301655
Title
President
Phone
(561) 659-1510

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
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

120A Butler St
West Palm Beach, FL 33407

Mailing address

120 Butler St
Suite a
West Palm Beach, FL 33407-6107
Phone (561) 659-1510

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040623001356 FL Part B Supplier - Clinic/Group Practice 6709861602 Receives reassigned benefits from 21 practitioners
Practice locations: Delray Beach, FL; West Palm Beach, FL; Wellington, FL; Palm Beach Gardens, FL; Atlantis, FL; Trinity, FL

National Provider Directory

National Provider Directory

Locations

120 John F Kennedy Dr
Ste 128
Atlantis, FL 33462

7280 W Palmetto Park Rd
Ste 207
Boca Raton, FL 33433
Phone (561) 278-1362

951 NW 13th St
Ste 2D
Boca Raton, FL 33486
Phone (561) 393-7488

10301 Hagen Ranch Rd
Ste 550
Boynton Beach, FL 33437
Phone (561) 739-5252

10301 Hagen Ranch Rd
Ste 930
Boynton Beach, FL 33437
Phone (561) 739-5251

2605 W Atlantic Ave
#D203D204
Delray Beach, FL 33445
Phone (561) 819-5822

2605 W Atlantic Ave
Ste D203
Delray Beach, FL 33445
Phone (561) 819-5822

400 E Linton Blvd
Ste G9
Delray Beach, FL 33483
Phone (561) 272-1137

10335 N Military Trl
Palm Beach Gardens, FL 33410

10335 N Military Trl
Ste A
Palm Beach Gardens, FL 33410
Phone (561) 622-6976

10355 A N Military TRL
Palm Beach Gardens, FL 33410
Phone (561) 622-6976

10355 N Military TRL Ste a
Palm Beach Gardens, FL 33410

650 SE Indian St
Ste 4
Stuart, FL 34997
Phone (772) 403-2227

10111 Forest Hill Blvd
Rm 100
West Palm Bch, FL 33414
Phone (561) 753-8366

120 Butler St
West Palm Beach, FL 33407
Phone (561) 659-1510

120 Butler St
Ste A
West Palm Beach, FL 33407
Phone (561) 659-1510

1830 N Dixie Hwy
West Palm Beach, FL 33407
Phone (561) 659-1510

Networks

  • HealthSun Health Plans Network

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397692800000",
    "number": "1649260308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 BUTLER ST",
            "address_2": "SUITE A",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334076107",
            "telephone_number": "561-659-1510",
            "fax_number": "561-659-0495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120A BUTLER ST",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "33407",
            "telephone_number": "561-659-1510",
            "fax_number": "561-659-0495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY ASSOCIATES OF THE PALM BEACHES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-25",
        "last_updated": "2014-04-17",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_middle_name": "ALEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-659-1510",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2014; 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.