NPIMap

Organization Active NPI

Irecovery, LLC

  • Clinical Social Worker
  • Hollywood, FL
National Provider Identifier
1710601943
Registry record updated Sep 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
IRECOVERY, LLC
Practice address
4000 Hollywood Blvd Ste 555S
Hollywood, FL 33021-6853
Phone
(954) 266-0983
Fax
(561) 464-5501
NPI assigned
Sep 30, 2022
Last updated
Sep 30, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2022

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

Authorized official

Name
Ms. Mildred Cintron
Title
Credentialing
Phone
(561) 235-7683

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Psychologist 103T00000X NU
Clinical Social Worker 1041C0700X NU Primary
Addiction Medicine (Family Medicine) Physician 207QA0401X NU
Physician Assistant 363A00000X NU

Addresses

Primary practice location

4000 Hollywood Blvd Ste 555S
Hollywood, FL 33021-6853

Mailing address

5030 Champion Blvd Ste G11-535
Boca Raton, FL 33496-2473
Phone (561) 235-7683

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200409000862 FL Part B Supplier - Clinic/Group Practice 3476982638 Receives reassigned benefits from 11 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Miami, FL; Orlando, FL; Ocala, FL; Pensacola, FL; Plant City, FL; Sarasota, FL; St Petersburg, FL; Tallahassee, FL…

Other NPIs on the same Medicare enrollment 15

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 15

National Provider Directory

National Provider Directory
Tax ID family
Irecovery LLC25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

Organizations that report the same tax identification number in the National Provider Directory.

View all 24

Locations

422 Fleming St
Key West, FL 33040
Phone (305) 600-5140

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1664496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664496000000",
    "number": "1710601943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5030 CHAMPION BLVD STE G11-535",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334962473",
            "telephone_number": "561-235-7683",
            "fax_number": "561-279-3351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 HOLLYWOOD BLVD STE 555S",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330216853",
            "telephone_number": "954-266-0983",
            "fax_number": "561-464-5501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRECOVERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-30",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-30",
        "status": "A",
        "authorized_official_last_name": "CINTRON",
        "authorized_official_first_name": "MILDRED",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "561-235-7683",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2022; 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.