Organization Active NPI

Jilleen M. Pannozzo, D.O., P.a.

  • Geriatric Psychiatry Physician
  • Boynton Beach, FL
National Provider Identifier
1649607136
Registry record updated Sep 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X
License
OS0005928 Issued in FL
Legal business name
JILLEEN M. PANNOZZO, D.O., P.A.
Practice address
10301 Hagen Ranch Rd
Suite 7
Boynton Beach, FL 33437-3724
Phone
(561) 733-4469
Fax
(561) 733-6858
NPI assigned
Sep 30, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2013

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

Authorized official

Name
Dr. Jilleen Marie Pannozzo, D.O.NPI 1730272477
Title
Psychiatrist
Phone
(561) 733-4469

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
Geriatric Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0805X OS0005928 FL Primary

Addresses

Primary practice location

10301 Hagen Ranch Rd
Suite 7
Boynton Beach, FL 33437-3724

Mailing address

10301 Hagen Ranch Rd
Suite 7
Boynton Beach, FL 33437-3724
Phone (561) 733-4469

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131127000732 FL Part B Supplier - Clinic/Group Practice 5193951986 Receives reassigned benefits from 1 practitioner
Practice locations: Boynton Beach, FL; Delray Beach, FL; Greenacres, FL; Lantana, FL; West Palm Beach, FL

National Provider Directory

National Provider Directory

Locations

10301 Hagen Ranch Rd
Ste 7
Boynton Beach, FL 33437
Phone (561) 733-4469

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": "1380499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380499200000",
    "number": "1649607136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10301 HAGEN RANCH RD",
            "address_2": "SUITE 7",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334373724",
            "telephone_number": "561-733-4469",
            "fax_number": "561-733-6858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10301 HAGEN RANCH RD",
            "address_2": "SUITE 7",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334373724",
            "telephone_number": "561-733-4469",
            "fax_number": "561-733-6858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JILLEEN M. PANNOZZO, D.O., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-30",
        "last_updated": "2013-09-30",
        "status": "A",
        "authorized_official_last_name": "PANNOZZO",
        "authorized_official_first_name": "JILLEEN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PSYCHIATRIST",
        "authorized_official_telephone_number": "561-733-4469",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "2084P0805X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "FL",
            "license": "OS0005928",
            "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 Sep 30, 2013; 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.