NPIMap

Organization Active NPI

Medical Specialists of the Palm Beaches Inc

  • Internal Medicine Physician
  • Atlantis, FL
National Provider Identifier
1821031048
Registry record updated Apr 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MEDICAL SPECIALISTS OF THE PALM BEACHES INC
Practice address
5401 S Congress Ave Ste 218
Atlantis, FL 33462-6337
Phone
(561) 433-0500
Fax
(561) 968-7673
NPI assigned
Jun 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2022

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

Authorized official

Name
Casey Waters
Title
Ceo
Phone
(561) 649-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

5401 S Congress Ave Ste 218
Atlantis, FL 33462-6337

Mailing address

5700 Lake Worth Rd
#204
Greenacres, FL 33463-4727
Phone (561) 968-7698

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031111000205 FL Part B Supplier - Clinic/Group Practice 0244143758 Receives reassigned benefits from 140 practitioners
19 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Med Spec of the Palm BC9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

5401 S Congress Ave
Ste 105
Atlantis, FL 33462
Phone (561) 642-8500

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649203200000",
    "number": "1821031048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 LAKE WORTH RD",
            "address_2": "#204",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334634727",
            "telephone_number": "561-968-7698",
            "fax_number": "561-964-4603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 S CONGRESS AVE STE 218",
            "city": "ATLANTIS",
            "state": "FL",
            "postal_code": "334626337",
            "telephone_number": "561-433-0500",
            "fax_number": "561-968-7673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL SPECIALISTS OF THE PALM BEACHES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A",
        "authorized_official_last_name": "WATERS",
        "authorized_official_first_name": "CASEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "561-649-7000"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlantis, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; 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.