NPIMap

Organization Active NPI

Physician Associates LLC

  • Pulmonary Disease Physician
  • Melbourne, FL
National Provider Identifier
1740504455
Registry record updated Mar 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
ME77004 Issued in FL
Legal business name
PHYSICIAN ASSOCIATES LLC
Practice address
2107 Dairy Rd
Melbourne, FL 32904-5209
Phone
(321) 259-1054
Fax
(321) 989-0246
NPI assigned
Mar 24, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2010

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

Authorized official

Name
Dennis J Buhring
Title
Ceo
Phone
(407) 262-5757

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X ME77004 FL Primary
Sleep Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RS0012X ME77004 FL

Addresses

Primary practice location

2107 Dairy Rd
Melbourne, FL 32904-5209

Mailing address

235 N Westmonte Dr
Altamonte Springs, FL 32714-3345
Phone (407) 262-5710

Other identifiers 2

IdentifierTypeStateIssuer
062757700MedicaidFL
97037OtherFLBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory
Tax ID family
Physician Associates LLC20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1269388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269388800000",
    "number": "1740504455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 N WESTMONTE DR",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327143345",
            "telephone_number": "407-262-5710",
            "fax_number": "407-262-5796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2107 DAIRY RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329045209",
            "telephone_number": "321-259-1054",
            "fax_number": "321-989-0246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-24",
        "last_updated": "2010-03-24",
        "status": "A",
        "authorized_official_last_name": "BUHRING",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "407-262-5757"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "ME77004",
            "primary": true
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "FL",
            "license": "ME77004",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "062757700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "97037",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.