Jeremy Joseph O'Brien, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

165962 Issued in FL

Practice address

951 N Washington Ave
Titusville, FL 32796-2163

Phone

(786) 969-7869

NPI assigned

Jun 3, 2014

Reactivated

Jan 28, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Diagnostic Radiology

Education

Univ of Western Ontario Schulich School of Med, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Intercoastal Medical Group IncGroup PAC ID 6305730912, 176 clinicians

Mori Bean and Brooks IncGroup PAC ID 8820077878, 966 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sacred Heart Hospital Hospital, Pensacola, FL, CCN 100025
• Ascension Sacred Heart Bay Hospital, Panama City, FL, CCN 100026
• Sarasota Memorial Hospital Hospital, Sarasota, FL, CCN 100087
• Parrish Medical Center Hospital, Titusville, FL, CCN 100028
• Sarasota Memorial Hospital - Venice Hospital, North Venice, FL, CCN 100359

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Intercoastal Medical Group Inc

  • Family Medicine Physician
  • Sarasota, FL
  • NPI 1578537767
  Medicare reassignment Care Compare group NPD
• Mori Bean and Brooks Inc

  dba Coastal Vein Vascular Institute

  • Diagnostic Radiology Physician
  • Tampa, FL
  • NPI 1093782070
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bay County Health System, LLC

  dba Ascension Sacred Heart Bay

  • General Acute Care Hospital
  • Panama City, FL
  • NPI 1720078041
  Care Compare affiliation
• North Brevard County Hospital District

  dba Parrish Medical Center

  • General Acute Care Hospital
  • Titusville, FL
  • NPI 1053424648
  Care Compare affiliation
• Sacred Heart Health System, Inc.

  dba Ascension Sacred Heart Pensacola

  • General Acute Care Hospital
  • Pensacola, FL
  • NPI 1922032424
  Care Compare affiliation
• Sarasota County Public Hospital District

  dba Sarasota Memorial Hospital - Venice

  • General Acute Care Hospital
  • North Venice, FL
  • NPI 1013534445
  Care Compare affiliation
• Sarasota County Public Hospital District

  dba Sarasota Memorial Hospital

  • General Acute Care Hospital
  • Sarasota, FL
  • NPI 1245294826
  Care Compare affiliation

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

{
    "created_epoch": "1401753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1447663802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "951 N WASHINGTON AVE",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327962163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "951 N WASHINGTON AVE",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327962163",
            "telephone_number": "786-969-7869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "JEREMY",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-03",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "deactivation_date": "2015-01-07",
        "reactivation_date": "2015-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "165962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• North Brevard Medical Support, Inc
• North Brevard Medical Support, Inc
• North Brevard Orthopedics
• Northland Hearing Centers, Inc. (Audibel Hearing Center)
• Darryl D Nugent Jr.
• Kera O'Brien
• Kristen O'Konski
• Carol Page O'Neal, PT
• Raena Oakley, OTR/L
• Jenna M Oates, MA CCC-SLP

• Diagnostic Radiology Physician in Titusville, FL
• Providers in Titusville, FL by specialty
• Diagnostic Radiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.