Space Coast Pathologists PA

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

Legal business name

SPACE COAST PATHOLOGISTS PA

Practice address

1350 S Hickory St
Dept. of Pathology
Melbourne, FL 32901-3278

Phone

(321) 434-7000

Fax

(321) 434-5295

NPI assigned

Nov 16, 2005

Last updated

Feb 13, 2008By 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

Carl T. Smedberg, M.D.NPI 1861474850

Title

President

Phone

(321) 953-4804

Specialties & licenses 1

Addresses

Other identifiers 1

Networks

• Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
• Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Practitioners 1

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.

• Carl T. Smedberg, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Melbourne, FL
  • NPI 1861474850
  Authorized official Same address or phone

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202860800000",
    "number": "1184606188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 144333",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328144333",
            "telephone_number": "407-422-9831",
            "fax_number": "407-648-2065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 S HICKORY ST",
            "address_2": "DEPT. OF PATHOLOGY",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013278",
            "telephone_number": "321-434-7000",
            "fax_number": "321-434-5295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPACE COAST PATHOLOGISTS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-16",
        "last_updated": "2008-02-13",
        "status": "A",
        "authorized_official_last_name": "SMEDBERG",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-953-4804",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "054991600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Space Coast Health Care Network
• Space Coast Health Care Services
• Space Coast Hearing and Balance, Inc.
• Space Coast Nephrology Associates, PLLC
• Space Coast Neuropsychology Center Inc
• Space Coast Pathologists PA
• Space Coast Sleep Disorders Center LLC
• Space Coast Speech and Language, LLC
• Space Coast Spine and Pain Institute LLC
• Space Coast Surgery LLC

• Anatomic Pathology & Clinical Pathology Physician in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Anatomic Pathology & Clinical Pathology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2008; 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.