Provider Demographics
| NPI: | 1619965795 |
|---|---|
| Name: | COMPASS HEALTH SYSTEMS, P.A. |
| Entity Type: | Organization |
| Organization Name: | COMPASS HEALTH SYSTEMS, P.A. |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | C.E.O. - PRESIDENT |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | SCOTT |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | SEGAL |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | MD |
| Authorized Official - Phone: | 888-852-6672 |
| Mailing Address - Street 1: | 1065 NE 125TH ST STE 300 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | NORTH MIAMI |
| Mailing Address - State: | FL |
| Mailing Address - Zip Code: | 33161-5833 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 888-852-6672 |
| Mailing Address - Fax: | 305-891-4228 |
| Practice Address - Street 1: | 1065 NE 125TH ST STE 206 |
| Practice Address - Street 2: | |
| Practice Address - City: | NORTH MIAMI |
| Practice Address - State: | FL |
| Practice Address - Zip Code: | 33161-5832 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 305-891-0050 |
| Practice Address - Fax: | 305-891-0497 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2005-10-12 |
| Last Update Date: | 2022-07-25 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| FL | 207Q00000X, 207R00000X, 2084P0800X, 2084P0804X, 208D00000X, 363LF0000X, 363LP0808X, 364SP0808X, 364SP0808X, 2084P0800X | |
| 2084N0400X, 2084P0802X, 363A00000X, 363LA2200X, 363LG0600X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 2084P0800X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | Group - Multi-Specialty |
| No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
| No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
| No | 2084N0400X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | Group - Multi-Specialty |
| No | 2084P0802X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Addiction Psychiatry | Group - Multi-Specialty |
| No | 2084P0804X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry | Group - Multi-Specialty |
| No | 208D00000X | Allopathic & Osteopathic Physicians | General Practice | Group - Multi-Specialty | |
| No | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Group - Multi-Specialty | |
| No | 363LA2200X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | Group - Multi-Specialty |
| No | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | Group - Multi-Specialty |
| No | 363LG0600X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Gerontology | Group - Multi-Specialty |
| No | 363LP0808X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psychiatric/Mental Health | Group - Multi-Specialty |
| No | 364SP0808X | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Psychiatric/Mental Health | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| FL | 374305513 | Medicaid | |
| FL | 374305525 | Medicaid | |
| FL | 374305500 | Medicaid | |
| FL | 374305519 | Medicaid | |
| FL | DG3396 | Other | MEDICARE RAILROAD GROUP NUMBER |
| FL | 374305518 | Medicaid | |
| FL | 374305519 | Medicaid | |
| FL | 374305527 | Medicaid | |
| FL | 374305500 | Medicaid | |
| FL | 374305524 | Medicaid | |
| FL | 374305508 | Medicaid | |
| FL | 374305527 | Medicaid | |
| FL | 99957 | Medicare PIN | |
| FL | 374305524 | Medicaid | |
| FL | 374305508 | Medicaid |
