Individual provider Active NPI

Craig Scott Altus, MD, FCCP

  • Pulmonary Disease Physician
  • Riviera Beach, FL
National Provider Identifier
1942390059
Registry record updated Jul 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
ME 49322 Issued in FL
Practice address
5555 W Blue Heron Blvd
Riviera Beach, FL 33418-7815
Phone
(561) 840-0754
NPI assigned
Oct 13, 2006
Last updated
Jul 7, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X ME 49322 FL Primary

Addresses

Primary practice location

5555 W Blue Heron Blvd
Riviera Beach, FL 33418-7815

Mailing address

PO Box 221257
West Palm Beach, FL 33422-1257
Phone (561) 835-6888

Other practice location 1

901 45th St
Mangonia Park, FL 33407-2413
Phone (561) 844-6300

Other practice location 2

1309 N Flagler Dr
West Palm Beach, FL 33401-3406
Phone (561) 655-5511

Other identifiers 1

IdentifierTypeStateIssuer
047554800MedicaidFL

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110212000080 FL Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 8325228091 Practice locations: Mangonia Park, FL; Riviera Beach, FL; West Palm Beach, FL

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME 49322FLMDPulmonary Disease Physician

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1942390059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 221257",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334221257",
            "telephone_number": "561-835-6888",
            "fax_number": "561-835-3888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 W BLUE HERON BLVD",
            "city": "RIVIERA BEACH",
            "state": "FL",
            "postal_code": "334187815",
            "telephone_number": "561-840-0754"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 45th St",
            "address_purpose": "LOCATION",
            "city": "Mangonia Park",
            "state": "FL",
            "postal_code": "334072413",
            "country_code": "US",
            "telephone_number": "561-844-6300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1309 N Flagler Dr",
            "address_purpose": "LOCATION",
            "city": "West Palm Beach",
            "state": "FL",
            "postal_code": "334013406",
            "country_code": "US",
            "telephone_number": "561-655-5511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALTUS",
        "first_name": "CRAIG",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "MD, FCCP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2021-07-07",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "ME 49322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "047554800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riviera Beach, FL

Sources for this page

Verify at the official NPI Registry.