Pinnacle Rehabilitation Group

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

Legal business name

PINNACLE REHABILITATION GROUP

Practice address

1680 SE Lyngate Dr Ste 204
Port Saint Lucie, FL 34952-4300

Phone

(772) 222-5411

Fax

(772) 237-5496

NPI assigned

Apr 22, 2019

Organization subpart

No

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

Authorized official

Name

Kenneth PalestrantNPI 1932218518

Title

Owner

Phone

(772) 222-5411

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 2

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

• Kenneth Palestrant, M.D.

  • Adult Medicine Physician
  • Port St Lucie, FL
  • NPI 1932218518
  Medicare reassignment NPD Authorized official
• Mark D. Polsky, DO

  • Family Medicine Physician
  • Palm City, FL
  • NPI 1265400709
  Medicare reassignment NPD

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

{
    "created_epoch": "1555891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556064000000",
    "number": "1780247064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1680 SE LYNGATE DR STE 204",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349524300",
            "telephone_number": "772-222-5411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 SE LYNGATE DR STE 204",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349524300",
            "telephone_number": "772-222-5411",
            "fax_number": "772-237-5496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE REHABILITATION GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-22",
        "last_updated": "2019-04-24",
        "status": "A",
        "authorized_official_last_name": "PALESTRANT",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-222-5411"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction Medicine (Family Medicine) Physician in Port Saint Lucie, FL
• Providers in Port Saint Lucie, FL by specialty
• Addiction Medicine (Family Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2019; 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.