Organization Active NPI

Advanced Neurology of the Palm Beaches, P.a.

  • Neurology Physician
  • Palm Beach Gardens, FL
National Provider Identifier
1790924835
Registry record updated Oct 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
ADVANCED NEUROLOGY OF THE PALM BEACHES, P.A.
Practice address
3400 Burns Rd Ste 101
Palm Beach Gardens, FL 33410-4352
Phone
(561) 626-1159
Fax
(561) 275-7050
NPI assigned
Feb 12, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2021

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

Authorized official

Name
Mr. Jose M Hernandez Jr.
Title
Credentialing Coordinator
Phone
(561) 626-1159

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

3400 Burns Rd Ste 101
Palm Beach Gardens, FL 33410-4352

Mailing address

3375 Burns Rd
Suite 203
Palm Beach Gardens, FL 33410-4349
Phone (561) 626-1159

Other practice location 1

3375 Burns Rd
Suite 203
Palm Beach Gardens, FL 33410-4349
Phone (561) 626-1159

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091015000673 FL Part B Supplier - Clinic/Group Practice 1254478647 Receives reassigned benefits from 1 practitioner
Practice locations: Palm Beach Gardens, FL

National Provider Directory

National Provider Directory

Locations

3375 Burns Rd
Ste 203
Palm Beach Gardens, FL 33410
Phone (561) 626-1159

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IHGDBA

Practitioners & affiliated clinicians

Practitioners 1

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": "1234396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633564800000",
    "number": "1790924835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3375 BURNS RD",
            "address_2": "SUITE 203",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334104349",
            "telephone_number": "561-626-1159",
            "fax_number": "561-626-5788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 BURNS RD STE 101",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334104352",
            "telephone_number": "561-626-1159",
            "fax_number": "561-275-7050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3375 Burns Rd",
            "address_2": "SUITE 203",
            "address_purpose": "LOCATION",
            "city": "Palm Beach Gardens",
            "state": "FL",
            "postal_code": "334104349",
            "country_code": "US",
            "telephone_number": "561-626-1159",
            "fax_number": "561-626-5788",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ADVANCED NEUROLOGY OF THE PALM BEACHES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-12",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "561-626-1159",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2021; 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.