Individual provider Active NPI

Jackie Lee Neubert, D.O.

  • Anesthesiology Physician
  • Melbourne, FL
National Provider Identifier
1457649238
Registry record updated Aug 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
OS16389 Issued in FL
Practice address
401 N Wickham Rd Ste L
Melbourne, FL 32935-8659
Phone
(321) 539-3634
NPI assigned
Jul 14, 2011
Last updated
Aug 23, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X OS16389 FL Primary

Addresses

Primary practice location

401 N Wickham Rd Ste L
Melbourne, FL 32935-8659

Mailing address

401 N Wickham Rd Ste L
Melbourne, FL 32935-8659
Phone (321) 539-3634

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
I20191121002660 FL Practitioner - Anesthesiology 6305153057 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brevard Physician Associates PLLCGroup PAC ID 1850535048, 221 clinicians

Practice addresses (Care Compare)

1350 Hickory St
Melbourne, FL 32901-3224
Phone (321) 434-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
279593-1NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Merritt Island Outpatient Surgery Center, LLC CurrentSince Jul 2, 2023 Accepting new patients
Brevard Physician Associates, PLLC Anesthesiology CurrentSince Jun 26, 2020 Accepting new patients

Locations

1350 Hickory St
Melbourne, FL 32901
Phone (321) 434-1771

450 E Merritt Island Cswy
Ste 400
Merritt Island, FL 32952
Phone (321) 735-6221

504 N Reo St
Tampa, FL 33609
Phone (813) 319-0911

Interoperability endpoints

  • Direct secure messaging: jneubert69549@epicdirect.hf.org

Organizations & group practices 2

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": "1310601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787443200000",
    "number": "1457649238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N WICKHAM RD STE L",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329358659",
            "telephone_number": "321-539-3634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N WICKHAM RD STE L",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329358659",
            "telephone_number": "321-539-3634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEUBERT",
        "first_name": "JACKIE",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-14",
        "last_updated": "2026-08-23",
        "certification_date": "2026-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "OS16389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.