Active NPI
Angela Pedraza, M.D.
- Specialist
- West Palm Beach, FL
National Provider Identifier
1710987573
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- ME0052121
- Practice address
- 1645 Palm Beach Lakes Blvd Ste 1200
West Palm Beach, FL 33401-2214 - Phone
- (561) 687-2111
- Fax
- (561) 687-1777
- NPI assigned
- Jul 22, 2005
- Last updated
- Aug 2, 2023
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | ME0052121 | FL | Primary |
Addresses
Primary practice location
1645 Palm Beach Lakes Blvd Ste 1200
West Palm Beach, FL 33401-2214
Mailing address
1645 Palm Beach Lakes Blvd Ste 1200
West Palm Beach, FL 33401-2214
Phone (561) 687-2111
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 Jul 11, 2013 through Jul 11, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME0052121 | FL | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121990400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690934400000",
"number": "1710987573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1645 PALM BEACH LAKES BLVD STE 1200",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334012214",
"telephone_number": "561-687-2111",
"fax_number": "561-687-1777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1645 PALM BEACH LAKES BLVD STE 1200",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334012214",
"telephone_number": "561-687-2111",
"fax_number": "561-687-1777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEDRAZA",
"first_name": "ANGELA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-07-22",
"last_updated": "2023-08-02",
"certification_date": "2023-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "FL",
"license": "ME0052121",
"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 Aug 2, 2023; 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.