Trillium Medical Center PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

OS10321 Issued in FL

Legal business name

TRILLIUM MEDICAL CENTER PLLC

Doing business as

Trillium Medical Center

Practice address

7545 W Boynton Beach Blvd
Suite 201
Boynton Beach, FL 33437-6166

Phone

(561) 906-3238

Fax

(561) 582-5204

NPI assigned

Jan 28, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Kimberly Ann Sussman, D.O.NPI 1386977262

Title

President

Phone

(561) 906-3238

Specialties & licenses 1

Addresses

Other names 1

• Trillium Medical Center Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kimberly Ann Sussman, D.O.

  • Internal Medicine Physician
  • Boynton Beach, FL
  • NPI 1386977262
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1296172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316649600000",
    "number": "1730485343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7545 W BOYNTON BEACH BLVD",
            "address_2": "SUIT 201",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334376166",
            "telephone_number": "561-736-0881",
            "fax_number": "561-736-0887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7545 W BOYNTON BEACH BLVD",
            "address_2": "SUITE 201",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334376166",
            "telephone_number": "561-906-3238",
            "fax_number": "561-582-5204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRILLIUM MEDICAL CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-28",
        "last_updated": "2011-09-22",
        "status": "A",
        "authorized_official_last_name": "SUSSMAN",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-906-3238",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS10321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trillium Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Internal Medicine Physician in Boynton Beach, FL
• Providers in Boynton Beach, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.