NPIMap

Organization Active NPI

Longevity Accountable Care, PA

  • Geriatric Medicine (Family Medicine) Physician
  • Royal Palm Beach, FL
National Provider Identifier
1801644711
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
Legal business name
LONGEVITY ACCOUNTABLE CARE, PA
Practice address
600 Business Park Way
Royal Palm Beach, FL 33411-1747
Phone
(561) 795-3583
NPI assigned
May 7, 2024
Last updated
May 7, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2024

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

Authorized official

Name
Diane Vincur
Title
Practice Manager
Phone
(561) 815-2427

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X
Primary Care Nurse Practitioner 363LP2300X
Family Medicine Physician 207Q00000X
Geriatric Medicine (Family Medicine) Physician 207QG0300X Primary

Addresses

Primary practice location

600 Business Park Way
Royal Palm Beach, FL 33411-1747

Mailing address

11780 US Highway 1 Ste N107
North Palm Beach, FL 33408-3007
Phone (561) 815-2427

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240709003960 FL Part B Supplier - Clinic/Group Practice 0840734034 Receives reassigned benefits from 19 practitioners

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Longevity Accountable Care5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

3855 Old Canoe Creek Rd
Saint Cloud, FL 34769
Phone (407) 900-4885

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1715040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715040000000",
    "number": "1801644711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11780 US HIGHWAY 1 STE N107",
            "city": "NORTH PALM BEACH",
            "state": "FL",
            "postal_code": "334083007",
            "telephone_number": "561-815-2427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 BUSINESS PARK WAY",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "334111747",
            "telephone_number": "561-795-3583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGEVITY ACCOUNTABLE CARE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-07",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A",
        "authorized_official_last_name": "VINCUR",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "561-815-2427"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; 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.