Brevard Neurology Associates PA

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

License

ME58732 Issued in FL

Legal business name

BREVARD NEUROLOGY ASSOCIATES PA

Practice address

1910 Rockledge Blvd
Unit 101
Rockledge, FL 32955

Phone

(321) 636-8366

Fax

(321) 636-3985

NPI assigned

Jan 13, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Wasim Niazi, MD

Title

Corporate Office

Phone

(321) 636-8366

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

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

• Muhammed Wasim Niazi, MD

  • Neurology Physician
  • Rockledge, FL
  • NPI 1215911433
  Medicare reassignment

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365724800000",
    "number": "1194704544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 ROCKLEDGE BLVD",
            "address_2": "UNIT 101",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "32955",
            "telephone_number": "321-636-8366",
            "fax_number": "321-636-3985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 ROCKLEDGE BLVD",
            "address_2": "UNIT 101",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "32955",
            "telephone_number": "321-636-8366",
            "fax_number": "321-636-3985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREVARD NEUROLOGY ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-13",
        "last_updated": "2013-04-12",
        "status": "A",
        "authorized_official_last_name": "NIAZI",
        "authorized_official_first_name": "WASIM",
        "authorized_official_title_or_position": "CORPORATE OFFICE",
        "authorized_official_telephone_number": "321-636-8366",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "FL",
            "license": "ME58732",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED",
            "identifier": "0500148",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "377423600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA GRP",
            "identifier": "5395693",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "26705",
            "identifier": "26705",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS GRP",
            "identifier": "45249",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4657556",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "130016629",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brevard Health Alliance Inc
• Brevard Health Alliance Inc
• Brevard Health Alliance Inc
• Brevard Hma HME, LLC
• Brevard Integrated Health Center LLC
• Brevard Pharmacy L.L.C.
• Brevard Physical Medicine
• Brevard Prosthetics & Orthotics, Inc
• Brevard Pulmonary Specialists PA
• Brevard Urology Associates PA

• Multi-Specialty Clinic/Center in Rockledge, FL
• Providers in Rockledge, FL by specialty
• Multi-Specialty Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2013; 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.