NPIMap

Organization Active NPI

Private Mental Health Group, LLC

  • Psychiatry Physician
  • Fort Lauderdale, FL
National Provider Identifier
1730875923
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
PRIVATE MENTAL HEALTH GROUP, LLC
Practice address
12 SE 7TH St Ste 705
Fort Lauderdale, FL 33301-3469
Phone
(954) 794-9000
Fax
(754) 800-2610
NPI assigned
Apr 12, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Authorized official

Name
Dr. Olga Katz, MDNPI 1992858096
Title
Medical Director
Phone
(917) 494-4975

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
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

12 SE 7TH St Ste 705
Fort Lauderdale, FL 33301-3469

Mailing address

3100 N Ocean Blvd Apt 603
Fort Lauderdale, FL 33308-7188
Phone (646) 512-3203

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250603002416 FL Part B Supplier - Clinic/Group Practice 0244749034 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Lauderdale, FL

National Provider Directory

National Provider Directory
Tax ID family
Private Mental Health Group LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 2

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": "1681257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681257600000",
    "number": "1730875923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 N OCEAN BLVD APT 603",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333087188",
            "telephone_number": "646-512-3203",
            "fax_number": "754-800-2610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 SE 7TH ST STE 705",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333013469",
            "telephone_number": "954-794-9000",
            "fax_number": "754-800-2610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIVATE MENTAL HEALTH GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-12",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A",
        "authorized_official_last_name": "KATZ",
        "authorized_official_first_name": "OLGA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "917-494-4975",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2023; 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.