NPIMap

Organization Active NPI

Indian River Health Services Inc

  • Internal Medicine Physician
  • Vero Beach, FL
National Provider Identifier
1124074455
Registry record updated Sep 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
INDIAN RIVER HEALTH SERVICES INC
Practice address
1155 35TH LN
Suite 201
Vero Beach, FL 32960-6521
Phone
(772) 794-3364
NPI assigned
May 26, 2006
Last updated
Sep 16, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2019

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

Authorized official

Name
Jeffrey L Susi
Title
Ceo
Phone
(772) 567-4311

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

1155 35TH LN
Suite 201
Vero Beach, FL 32960-6521

Mailing address

1000 36TH St
Vero Beach, FL 32960-4862

Other identifiers 2

IdentifierTypeStateIssuer
275383901MedicaidFL
39813COtherFLBLUE CROSS

Other names 1

  • Vero Internal Medicine Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070116000060 FL Part B Supplier - Clinic/Group Practice 9234130329 Receives reassigned benefits from 535 practitioners
39 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Vero Beach, FL; West Palm Beach, FL; Weston, FL; Hobe Sound, FL; Palm City, FL; Port Saint Lucie, FL; Sebastian, FL; Stuart, FL

Other NPIs on the same Medicare enrollment 39

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 39

National Provider Directory

National Provider Directory
Tax ID family
Indian River Health Services Inc26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

Organizations that report the same tax identification number in the National Provider Directory.

View all 25

Locations (25 of 27)

10080 SW Innovation Way
Ste 201
Port St Lucie, FL 34987
Phone (772) 344-3811

1095 NW Saint Lucie West Blvd
Ste 108
Port St Lucie, FL 34986
Phone (561) 785-5580

13885 US Highway 1
Ste 1
Sebastian, FL 32958

801 Wellness Way
Ste 109
Sebastian, FL 32958
Phone (772) 226-4200

801 Wellness Way
Ste 201
Sebastian, FL 32958
Phone (772) 388-5402

3801 S Kanner Hwy
Stuart, FL 34994
Phone (772) 223-4959

1000 36th St
Ste 2232
Vero Beach, FL 32960

1000 36th St
Ste C
Vero Beach, FL 32960

1040 37th Pl
Ste 200
Vero Beach, FL 32960
Phone (772) 563-4741

1050 37th Pl
Vero Beach, FL 32960
Phone (772) 770-6116

1050 37th Pl
#102103
Vero Beach, FL 32960

1050 37th Pl
Ste 101103
Vero Beach, FL 32960
Phone (772) 770-6116

1050 37th Pl
Ste 103
Vero Beach, FL 32960
Phone (772) 770-6116

1155 35th Ln
Ste 204
Vero Beach, FL 32960
Phone (772) 563-4591

1960 Pointe West Dr
Ste 101102
Vero Beach, FL 32966

3450 11th Ct
Vero Beach, FL 32960
Phone (203) 815-4738

3450 11th Ct
#104A
Vero Beach, FL 32960
Phone (772) 226-4830

3450 11th Ct
#302A
Vero Beach, FL 32960

3450 11th Ct
Ste 201
Vero Beach, FL 32960
Phone (772) 794-3364

3450 11th Ct
Ste 206
Vero Beach, FL 32960
Phone (772) 299-3511

3450 11th Ct
Ste 301
Vero Beach, FL 32960
Phone (772) 563-4741

3450 11th Ct
Ste 302B
Vero Beach, FL 32960
Phone (772) 569-8550

3450 11th Ct
Ste 303
Vero Beach, FL 32960
Phone (772) 794-9771

3450 11th Ct
Ste 99
Vero Beach, FL 32960
Phone (772) 770-6850

3555 10th Ct
Ste 101B
Vero Beach, FL 32960
Phone (772) 563-4646

Practitioners & affiliated clinicians

Practitioners 110

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 110

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568592000000",
    "number": "1124074455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 36TH ST",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329604862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 35TH LN",
            "address_2": "SUITE 201",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329606521",
            "telephone_number": "772-794-3364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIAN RIVER HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2019-09-16",
        "status": "A",
        "authorized_official_last_name": "SUSI",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "772-567-4311"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "275383901",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "39813C",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vero Internal Medicine",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Vero Internal Medicine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Vero Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.