Individual provider Active NPI

Rachelle Lacey

  • Dermatology Physician
  • Palm Beach Gardens, FL
National Provider Identifier
1740669605
Registry record updated May 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
ME12916 Issued in FL
Practice address
600 Village Square Xing
Palm Beach Gardens, FL 33410-4543
Phone
(561) 694-9493
Fax
(561) 694-9064
NPI assigned
May 26, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X ME12916 FL Primary

Addresses

Primary practice location

600 Village Square Xing
Palm Beach Gardens, FL 33410-4543

Mailing address

600 Village Square Xing
Palm Beach Gardens, FL 33410-4543
Phone (561) 694-9493

Other names 1

  • Rachelle Lacey Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200708000793 FL Practitioner - Dermatology 2567755820 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Howard University College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aqua Dermatology of Florida, PAGroup PAC ID 1153390414, 184 clinicians

Practice addresses (Care Compare)

3659 S Miami Ave
Suite 6008
Miami, FL 33133-4221
Phone (305) 856-6555

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions847
Removal or shaving of skin growth25
Skin biopsy274

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME12916FLMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aqua Dermatology of Florida, PA Dermatology CurrentSince Jan 1, 2022 Accepting new patients
Water's Edge Dermatology, LLC Dermatology CurrentSince Aug 15, 2020 Accepting new patients
Water's Edge Dermatology, LLC CurrentSince Aug 15, 2020 Accepting new patients
Naples Center for Dermatology & Riverchase Dermatology CurrentSince Jan 1, 2022 Accepting new patients

Locations

200 Glades Rd
Ste 1
Boca Raton, FL 33432
Phone (561) 395-7704

9980 Central Park Blvd N
Ste 124
Boca Raton, FL 33428
Phone (561) 372-7546

15300 S Jog Rd
Ste 202
Delray Beach, FL 33446
Phone (561) 455-5601

6642 Atlantic Ave
Delray Beach, FL 33446
Phone (561) 865-1212

5101 Okeechobee Rd
Fort Pierce, FL 34947
Phone (772) 595-5995

6250 Lantana Rd
Ste 9
Lake Worth, FL 33463
Phone (561) 578-8100

3659 S Miami Ave
Ste 6008
Miami, FL 33133
Phone (305) 854-5432

1015 Crosspointe Dr
Naples, FL 34110
Phone (239) 596-9075

14840 Tamiami Trl
North Port, FL 34287
Phone (941) 564-1542

301 NE 19th Dr
Okeechobee, FL 34972
Phone (863) 357-0039

2845 Pga Blvd
Palm Beach Gardens, FL 33410
Phone (561) 693-0540

600 Village Square Xing
Palm Beach Gardens, FL 33410
Phone (561) 693-0540

264 NW Peacock Blvd
Ste 201
St Lucie West, FL 34986
Phone (772) 323-2321

38162 Medical Center Ave
Zephyrhills, FL 33540
Phone (813) 782-2165

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: rlacey@aquadermatology.emadirect.md

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1432598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651881600000",
    "number": "1740669605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 VILLAGE SQUARE XING",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334104543",
            "telephone_number": "561-694-9493",
            "fax_number": "561-694-9064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 VILLAGE SQUARE XING",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334104543",
            "telephone_number": "561-694-9493",
            "fax_number": "561-694-9064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACEY",
        "first_name": "RACHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-26",
        "last_updated": "2022-05-07",
        "certification_date": "2022-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME12916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHELLE",
            "last_name": "LACEY",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Palm Beach Gardens, FL

Sources for this page

Verify at the official NPI Registry.