NPIMap

Organization Active NPI

Sma Healthcare Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Inverness, FL
National Provider Identifier
1366014615
Registry record updated Jul 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
SMA HEALTHCARE INC
Practice address
107 Dr Martin Luther King Jr Ave
Inverness, FL 34450-4341
Phone
(352) 291-5555
NPI assigned
Jul 15, 2021
Last updated
Jul 15, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2021

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

Authorized official

Name
Mr. Ivan Cosimi
Title
Ceo
Phone
(386) 236-1811

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

107 Dr Martin Luther King Jr Ave
Inverness, FL 34450-4341

Mailing address

150 Magnolia Ave
Daytona Beach, FL 32114-4304
Phone (386) 236-3215

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040423000483 FL Part B Supplier - Clinic/Group Practice 0244226363 Receives reassigned benefits from 112 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: St Augustine, FL; Saint Augustine, FL; Palatka, FL; Ocala, FL; New Smyrna Beach, FL; Inverness, FL; Deland, FL; Debary, FL…

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory
Tax ID family
Gale J Deacon29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

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

View all 28

Practitioners & affiliated clinicians

Practitioners 16

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 16

NPI Registry JSON

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

{
    "created_epoch": "1626307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626307200000",
    "number": "1366014615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 MAGNOLIA AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321144304",
            "telephone_number": "386-236-3215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 DR MARTIN LUTHER KING JR AVE",
            "city": "INVERNESS",
            "state": "FL",
            "postal_code": "344504341",
            "telephone_number": "352-291-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMA HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-15",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A",
        "authorized_official_last_name": "COSIMI",
        "authorized_official_first_name": "IVAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "386-236-1811",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Inverness, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; 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.