Organization Active NPI

Quality Medical Care PA

  • Interventional Cardiology Physician
  • Melbourne, FL
National Provider Identifier
1114912607
Registry record updated Aug 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
Legal business name
QUALITY MEDICAL CARE PA
Practice address
675 S Babcock St
Melbourne, FL 32901-1459
Phone
(321) 951-8695
Fax
(321) 956-8937
NPI assigned
Sep 12, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2016

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

Authorized official

Name
Subash K Thareja, MD
Title
President
Phone
(321) 951-1010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0011X FL Primary

Addresses

Primary practice location

675 S Babcock St
Melbourne, FL 32901-1459

Mailing address

675 S Babcock St
Melbourne, FL 32901-1459
Phone (321) 951-1010

Other identifiers 1

IdentifierTypeStateIssuer
253423100MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031208000914 FL Part B Supplier - Clinic/Group Practice 2567368996 Receives reassigned benefits from 9 practitioners
Practice locations: Palm Bay, 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
10D0878114Quality Medical Care PA675 S Babcock St, Melbourne, FL 32901Certificate of waiverOct 17, 2027
10D0878124Quality Medical Care PA675 S Babcock St, Melbourne, FL 32901Certificate of waiverOct 17, 2027

National Provider Directory

National Provider Directory

Locations

675 S Babcock St
Ste 200
Melbourne, FL 32901

675 S Babcock St
#1
Melbourne, FL 32901

675 S Babcock St
Ste 10
Melbourne, FL 32901

675 S Babcock St
Ste 1
Melbourne, FL 32901
Phone (321) 951-1010

5200 Babcock St NE
Ste 106
Palm Bay, FL 32905

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11690/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470096000000",
    "number": "1114912607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 S BABCOCK ST",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329011459",
            "telephone_number": "321-951-1010",
            "fax_number": "321-952-4038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 S BABCOCK ST",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329011459",
            "telephone_number": "321-951-8695",
            "fax_number": "321-956-8937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUALITY MEDICAL CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-12",
        "last_updated": "2016-08-02",
        "status": "A",
        "authorized_official_last_name": "THAREJA",
        "authorized_official_first_name": "SUBASH",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-951-1010",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "253423100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 2, 2016; 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.