Active NPI
Devra Caryn Mintz, M.D., M.P.H.
- Psychiatry Physician
- Weston, FL
National Provider Identifier
1710002647
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- ME79243
- Practice address
- 17120 Royal Palm Blvd
Suite 1
Weston, FL 33326-2310 - Phone
- (954) 349-2277
- Fax
- (954) 446-6919
- NPI assigned
- Mar 20, 2007
- Last updated
- Jun 9, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | ME79243 | FL | Primary |
Addresses
Primary practice location
17120 Royal Palm Blvd
Suite 1
Weston, FL 33326-2310
Mailing address
17120 Royal Palm Blvd
Suite 1
Weston, FL 33326-2310
Phone (954) 349-2277
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Aug 21, 2017 through Aug 21, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME79243 | FL | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1370736000000",
"number": "1710002647",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17120 ROYAL PALM BLVD",
"address_2": "SUITE 1",
"city": "WESTON",
"state": "FL",
"postal_code": "333262310",
"telephone_number": "954-349-2277",
"fax_number": "954-446-6919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17120 ROYAL PALM BLVD",
"address_2": "SUITE 1",
"city": "WESTON",
"state": "FL",
"postal_code": "333262310",
"telephone_number": "954-349-2277",
"fax_number": "954-446-6919"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MINTZ",
"first_name": "DEVRA",
"middle_name": "CARYN",
"name_prefix": "Dr.",
"credential": "M.D., M.P.H.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-20",
"last_updated": "2013-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "FL",
"license": "ME79243",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Weston, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.