Melbourne Podiatry Associates, P.a.

Primary specialty

PodiatristTaxonomy code 213E00000X

Legal business name

MELBOURNE PODIATRY ASSOCIATES, P.A.

Doing business as

Melbourne Podiatry Associates

Practice address

1515 Dr Martin Luther King Jr Blvd
Melbourne, FL 32901-2946

Phone

(321) 723-3500

Fax

(321) 723-1945

NPI assigned

Nov 28, 2005

Last updated

May 12, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jared B Moyles, DPMNPI 1457589244

Title

President

Phone

(321) 723-3500

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Melbourne Podiatry Associates Doing business as

Medicare fee-for-service enrollment

Enrolled in FL2 enrollments

Enrollment records 2

Tax ID family

Briant G Moyles DPM PA3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Briant G Moyles DPM PA

  • Podiatrist
  • Palm Bay, FL
  • NPI 1275068215
  NPD tax ID
• Briant G. Moyles D.P.M., P.a.

  dba Melbourne Podiatry Associates

  • Podiatrist
  • Melbourne, FL
  • NPI 1194998286
  NPD tax ID

Locations

Practitioners 4

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.

• Jared Briant Moyles, D.P.M

  • Podiatrist
  • Melbourne, FL
  • NPI 1457589244
  Medicare reassignment Care Compare group NPD Authorized official
• Jessica Ann Ortega Wilson, DPM

  • Podiatrist
  • Melbourne, FL
  • NPI 1558701243
  Medicare reassignment Care Compare group NPD
• Richard C Wilson, DPM

  • Foot & Ankle Surgery Podiatrist
  • Melbourne, FL
  • NPI 1972587350
  Medicare reassignment Care Compare group NPD
• Thomas Charles Wilson, DPM

  • Podiatrist
  • Melbourne, FL
  • NPI 1184064834
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1133136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683849600000",
    "number": "1174506877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 DR MARTIN LUTHER KING JR BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329012946",
            "telephone_number": "321-723-3500",
            "fax_number": "321-723-1945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 DR MARTIN LUTHER KING JR BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329012946",
            "telephone_number": "321-723-3500",
            "fax_number": "321-723-1945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELBOURNE PODIATRY ASSOCIATES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-28",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A",
        "authorized_official_last_name": "MOYLES",
        "authorized_official_first_name": "JARED",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-723-3500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "72224",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "041009800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Melbourne Podiatry Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Melbourne Podiatry Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Melbourne Medpsych PLLC
• Melbourne Mobile Podiatry
• Melbourne Opco, LLC (Nursing & Rehabilitation Center of Melbourne)
• Melbourne Pharma
• Melbourne Physician Services, LLC
• Melbourne Surgery Center LP
• Melbourne Surgery Center, LLC (Melbourne Surgery Center)
• Melbourne Terrace RCC, LLC (Melbourne Terrace Rehabilitation Center)
• Melbourne United Laser Vision Association LLC
• Melbourne Urgent Care, LLC

• Podiatrist in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Podiatrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2023; 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.