Organization Active NPI

Care Level Management Medical Group Florida, LLC

  • General Practice Physician
  • Melbourne, FL
National Provider Identifier
1063548287
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
CARE LEVEL MANAGEMENT MEDICAL GROUP FLORIDA, LLC
Doing business as
Care Level Management
Practice address
1958 Dairy Rd
Melbourne, FL 32904-4045
Phone
(800) 530-5441
Fax
(818) 595-8206
NPI assigned
Feb 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Richard St.Andrew
Title
Credentialing Coordinator
Phone
(800) 377-3606

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

1958 Dairy Rd
Melbourne, FL 32904-4045

Mailing address

5700 Canoga Ave
Suite 500
Woodland Hills, CA 91367-6579
Phone (800) 377-3606

Other names 1

  • Care Level Management Doing business as

National Provider Directory

National Provider Directory

Locations

1958 Dairy Rd
Melbourne, FL 32904
Phone (321) 409-0010

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": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063548287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 CANOGA AVE",
            "address_2": "SUITE 500",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913676579",
            "telephone_number": "800-377-3606",
            "fax_number": "818-595-8206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1958 DAIRY RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329044045",
            "telephone_number": "800-530-5441",
            "fax_number": "818-595-8206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARE LEVEL MANAGEMENT MEDICAL GROUP FLORIDA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ST.ANDREW",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "800-377-3606"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Care Level Management",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.