Individual provider Active NPI

Richard Joseph Palmeri, PA

  • Surgical Physician Assistant
  • West Palm Beach, FL
National Provider Identifier
1891757126
Registry record updated Sep 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA3266 Issued in FL
Practice address
901 45TH Street
Kimmel BLDG
West Palm Beach, FL 33407-2413
Phone
(561) 844-5255
Fax
(561) 844-5245
NPI assigned
Apr 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA3266 FL
Surgical Physician Assistant 363AS0400X PA3266 FL Primary

Addresses

Primary practice location

901 45TH Street
Kimmel BLDG
West Palm Beach, FL 33407-2413

Mailing address

1936 32ND Ave. Spine & Joint Treatment Center
Vero Beach, FL 32960
Phone (772) 778-8882

Other practice location 1

3002 SE Bur St
Port Saint Lucie, FL 34952-5855
Phone (772) 337-4243

Other identifiers 5

IdentifierTypeStateIssuer
X1624OtherBCBS
290455100MedicaidFL
Y05FAOtherBCBS
JP371MedicaidFL
MM303MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061102000126 FL Practitioner - Physician Assistant 4183639081 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bower Urology LLCGroup PAC ID 3476915802, 2 clinicians

Practice addresses (Care Compare)

1941 SE Port St Lucie Blvd
Port Saint Lucie, FL 34952-5535
Phone (772) 340-6777

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA3266FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Orthopaedics & Sports Medicine Center Past Accepting new patients
Physician Assistant Surgical Services, Inc. Surgical PastSince Feb 14, 2006 Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663027200000",
    "number": "1891757126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1936 32ND AVE. SPINE & JOINT TREATMENT CENTER",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "32960",
            "telephone_number": "772-778-8882",
            "fax_number": "772-778-8894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 45TH STREET",
            "address_2": "KIMMEL BLDG",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334072413",
            "telephone_number": "561-844-5255",
            "fax_number": "561-844-5245"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3002 SE Bur St",
            "address_purpose": "LOCATION",
            "city": "Port Saint Lucie",
            "state": "FL",
            "postal_code": "349525855",
            "country_code": "US",
            "telephone_number": "772-337-4243",
            "fax_number": "772-337-4243",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PALMERI",
        "first_name": "RICHARD",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA3266",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA3266",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "X1624",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "290455100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y05FA",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "JP371",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MM303",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.