NPIMap

Individual provider Active NPI

John C Brock, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • St Petersburg, FL
National Provider Identifier
1154327393
Registry record updated Sep 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
ME41814 Issued in FL
Practice address
601 7TH St S Ste 205
St Petersburg, FL 33701-4748
Phone
(727) 553-7450
Fax
(727) 553-7451
NPI assigned
Jun 22, 2005
Last updated
Sep 10, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X ME41814 FL Primary

Addresses

Primary practice location

601 7TH St S Ste 205
St Petersburg, FL 33701-4748

Mailing address

601 7TH St S Ste 205
St Petersburg, FL 33701-4748
Phone (727) 553-7450

Other names 1

  • Dr. Jack Brock Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070721000010 FL Practitioner - Thoracic SurgeryPractitioner - Internal Medicine 3678674538 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Thoracic Surgery
Education
University of Florida College of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohi West Medical Group LLCGroup PAC ID 2668882507, 200 clinicians

Practice addresses (Care Compare)

601 7TH St S
Suite 205
St Petersburg, FL 33701-4748
Phone (727) 893-6234

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Indian River Health Services Inc CurrentSince Feb 1, 2017 Accepting new patients
Orlando Health, Inc. Current Accepting new patients
Ohi West Medical Group, LLC CurrentSince Aug 15, 2021 Accepting new patients
Ohi West Medical Group, LLC CurrentSince Aug 15, 2021 Accepting new patients
Indian River Health Services Inc CurrentSince Feb 1, 2017 Accepting new patients
John C Brock MD PL Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients
Rockledge Hma Medical Group, LLC Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients
Florida Cardiovascular Institute PA Past Accepting new patients
Ocala Health Surgical Group LLC Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients
Premier Dermatology, LLC PastSince Jan 1, 2018 Accepting new patients

Locations

601 7th St S
Ste 205
St Petersburg, FL 33701
Phone (727) 893-6234

701 6th St S
St Petersburg, FL 33701
Phone (727) 450-1144

1190 37th St
Vero Beach, FL 32960
Phone (772) 563-4666

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: jbrock244300@orlandohealth.medalliesdirect.net
  • Direct secure messaging: john.brock.1@7598.direct.athenahealth.com

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1154327393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 7TH ST S STE 205",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014748",
            "telephone_number": "727-553-7450",
            "fax_number": "727-553-7451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 7TH ST S STE 205",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014748",
            "telephone_number": "727-553-7450",
            "fax_number": "727-553-7451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "JOHN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "FL",
            "license": "ME41814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACK",
            "last_name": "BROCK",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.