Organization Active NPI

VS Primo Health Care P a

  • Family Medicine Physician
  • Rockledge, FL
National Provider Identifier
1063547784
Registry record updated Sep 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
VS PRIMO HEALTH CARE P A
Practice address
840 Executive LN Ste 110
Rockledge, FL 32955-3519
Phone
(321) 751-7113
Fax
(321) 751-7114
NPI assigned
Feb 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2021

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

Authorized official

Name
Vincent Sciortino, MDNPI 1245290840
Title
Medical Doctor
Phone
(321) 751-7113

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X FL Primary

Addresses

Primary practice location

840 Executive LN Ste 110
Rockledge, FL 32955-3519

Mailing address

840 Executive LN Ste 110
Rockledge, FL 32955-3519
Phone (321) 751-7113

Other practice location 1

7000 Spyglass Ct
Ste 130
Viera, FL 32940-7948
Phone (321) 751-7113

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051230000385 FL Part B Supplier - Clinic/Group Practice 4587686704 Receives reassigned benefits from 1 practitioner
Practice locations: Rockledge, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1049638VS Primo Health Care PA840 Executive LN Ste 110, Rockledge, FL 32955Certificate of waiverJan 11, 2028

National Provider Directory

National Provider Directory

Locations

840 Executive Ln
Ste 110
Rockledge, FL 32955
Phone (321) 639-3130

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631577600000",
    "number": "1063547784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 EXECUTIVE LN STE 110",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329553519",
            "telephone_number": "321-751-7113",
            "fax_number": "321-751-7114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 EXECUTIVE LN STE 110",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329553519",
            "telephone_number": "321-751-7113",
            "fax_number": "321-751-7114"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7000 Spyglass Ct",
            "address_2": "Ste 130",
            "address_purpose": "LOCATION",
            "city": "Viera",
            "state": "FL",
            "postal_code": "329407948",
            "country_code": "US",
            "telephone_number": "321-751-7113",
            "fax_number": "321-751-7114",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VS PRIMO HEALTH CARE P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2021-09-14",
        "certification_date": "2020-08-24",
        "status": "A",
        "authorized_official_last_name": "SCIORTINO",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "321-751-7113",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockledge, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.