NPIMap

Organization Active NPI

Palm Beach Neurology

  • Neurology Physician
  • West Palm Beach, FL
National Provider Identifier
1821133950
Registry record updated Mar 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
PALM BEACH NEUROLOGY
Practice address
4631 Noth Congress Ave
200
West Palm Beach, FL 33407
Phone
(561) 845-0500
Fax
(561) 296-1101
NPI assigned
Feb 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2010

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

Authorized official

Name
Mrs. Chris Polanco
Title
Billing MGR
Phone
(561) 296-3851

Specialties & licenses 1

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

Addresses

Primary practice location

4631 Noth Congress Ave
200
West Palm Beach, FL 33407

Mailing address

4631 North Congress Ave
200
West Palm Beach, FL 33407
Phone (561) 845-0500

Other identifiers 1

IdentifierTypeStateIssuer
CG1538OtherFLRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040330001221 FL Part B Supplier - Clinic/Group Practice 5698767887 Receives reassigned benefits from 13 practitioners
3 other NPIs on this enrollment
Practice locations: Royal Palm Beach, FL; West Palm Beach, FL

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Tax ID family
Palm Beach Neurology4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

4631 N Congress Ave
West Palm Beach, FL 33407

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267488000000",
    "number": "1821133950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4631 NORTH CONGRESS AVE",
            "address_2": "200",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "33407",
            "telephone_number": "561-845-0500",
            "fax_number": "561-296-1101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4631 NOTH CONGRESS AVE",
            "address_2": "200",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "33407",
            "telephone_number": "561-845-0500",
            "fax_number": "561-296-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALM BEACH NEUROLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2010-03-02",
        "status": "A",
        "authorized_official_last_name": "POLANCO",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "BILLING MGR",
        "authorized_official_telephone_number": "561-296-3851",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CG1538",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2010; 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.