Individual provider Active NPI

Adam Bruggeman

  • Physician Assistant
  • Atlantis, FL
National Provider Identifier
1932988193
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9117926 Issued in FL
Practice address
180 John F Kennedy Dr Ste 100
Atlantis, FL 33462-6641
Phone
(561) 967-6500
NPI assigned
Sep 27, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9117926 FL
Surgical Physician Assistant 363AS0400X PA9117926 FL
Physician Assistant 363A00000X PA9117926 FL Primary

Addresses

Primary practice location

180 John F Kennedy Dr Ste 100
Atlantis, FL 33462-6641

Mailing address

1192 Summerwood Cir
Wellington, FL 33414-5149
Phone (561) 601-0628

Other practice location 1

1221 S State Road 7 Ste 200
Wellington, FL 33414-6204
Phone (561) 967-6500

Other practice location 2

10275 Hagen Ranch Rd Ste 200
Boynton Beach, FL 33437-3784
Phone (561) 967-6500

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
I20231018000164 FL Practitioner - Physician Assistant 9638524234 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9117926FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Center of Palm Beach County, LLC CurrentSince Oct 2, 2023 Accepting new patients
Orthopedic Center of Palm Beach County CurrentSince Oct 2, 2023 Accepting new patients
Orthopedic Center of Palm Beach County, Inc. Past Accepting new patients
Orthopedic Center of Palm Beach County, LLC Past Accepting new patients

Locations

4705 N Federal Hwy
Boca Raton, FL 33431
Phone (561) 220-2622

1905 Clint Moore Rd
Ste 214
Boca Raton, FL 33496
Phone (561) 241-8668

10275 Hagen Ranch Rd
Ste 200
Boynton Beach, FL 33437
Phone 5619676500 ext. 1324

1221 S State Road 7
Ste 200
Wellington, FL 33414
Phone (561) 697-6500

Interoperability endpoints

  • Direct secure messaging: adam.bruggeman.1@26475.direct.athenahealth.com

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1695772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1932988193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1192 SUMMERWOOD CIR",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334145149",
            "telephone_number": "561-601-0628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 JOHN F KENNEDY DR STE 100",
            "city": "ATLANTIS",
            "state": "FL",
            "postal_code": "334626641",
            "telephone_number": "561-967-6500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1221 S State Road 7 Ste 200",
            "address_purpose": "LOCATION",
            "city": "Wellington",
            "state": "FL",
            "postal_code": "334146204",
            "country_code": "US",
            "telephone_number": "561-967-6500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10275 Hagen Ranch Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Boynton Beach",
            "state": "FL",
            "postal_code": "334373784",
            "country_code": "US",
            "telephone_number": "561-967-6500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUGGEMAN",
        "first_name": "ADAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-27",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9117926",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9117926",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9117926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlantis, FL

Sources for this page

Verify at the official NPI Registry.