Individual provider Active NPI

Justin Andrew Muskovich, M.D.

  • Urology Physician
  • Port St Lucie, FL
National Provider Identifier
1396062337
Registry record updated Feb 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
ME123515 Issued in FL
Practice address
293 NW Peacock Blvd Ste 204
Port St Lucie, FL 34986-2222
Phone
(772) 879-4667
Fax
(772) 879-4478
NPI assigned
Apr 30, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X ME123515 FL Primary

Addresses

Primary practice location

293 NW Peacock Blvd Ste 204
Port St Lucie, FL 34986-2222

Mailing address

293 NW Peacock Blvd Ste 204
Port St Lucie, FL 34986-2222
Phone (772) 879-4667

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address JUSTIN.MUSKOVICH@hca4.eclinicaldirectplus.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151008000585 FL Practitioner - Urology 7113235391 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Toledo Medical College, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lucie Medical Specialists LLCGroup PAC ID 1456430487, 39 clinicians

Practice addresses (Care Compare)

1700 S 23Rd St
Fort Pierce, FL 34950-4803
Phone (772) 461-4000

1800 SE Tiffany Ave
Port Saint Lucie, FL 34952-7521
Phone (772) 335-4000

1881 SE Tiffany Ave
Port Saint Lucie, FL 34952-7567

2505 SW Martin Hwy
Palm City, FL 34990-3149
Phone (772) 288-1015

293 NW Peacock Blvd
Port Saint Lucie, FL 34986-2222

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Lucie Medical Specialists LLC CurrentSince Sep 1, 2018 Accepting new patients

Locations

2505 SW Martin Hwy
Palm City, FL 34990
Phone (772) 288-0060

1700 SE Hillmoor Dr
Ste 101
Port St Lucie, FL 34952
Phone (772) 288-2992

140 SW Chamber Ct
Ste 100
Port St Lucie, FL 34986
Phone (772) 355-9600

293 NW Peacock Blvd
Ste 204
Saint Lucie West, FL 34986
Phone (772) 879-4667

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 1

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 5

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": "1272585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1396062337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "293 NW PEACOCK BLVD STE 204",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349862222",
            "telephone_number": "772-879-4667",
            "fax_number": "772-879-4478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "293 NW PEACOCK BLVD STE 204",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349862222",
            "telephone_number": "772-879-4667",
            "fax_number": "772-879-4478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSKOVICH",
        "first_name": "JUSTIN",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-30",
        "last_updated": "2022-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME123515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "JUSTIN.MUSKOVICH@hca4.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "293 NW Peacock Blvd Ste 204",
            "city": "Port St Lucie",
            "state": "FL",
            "country_code": "US",
            "postal_code": "349862222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.