Individual provider Active NPI

Christopher J Prusinski, DO

  • Neurology Physician
  • Melbourne, FL
National Provider Identifier
1467556779
Registry record updated Aug 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
OS0005640 Issued in FL
Practice address
1310 W Eau Gallie Blvd
Suite B
Melbourne, FL 32935-5300
Phone
(321) 421-6566
Fax
(321) 421-6572
NPI assigned
Sep 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X OS0005640 FL Primary

Addresses

Primary practice location

1310 W Eau Gallie Blvd
Suite B
Melbourne, FL 32935-5300

Mailing address

1310 W Eau Gallie Blvd
Suite B
Melbourne, FL 32935-5300
Phone (321) 421-6566

Other identifiers 1

IdentifierTypeStateIssuer
80190OtherFLBCBS

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
I20080116000665 FL Practitioner - Neurology 2062593924 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Ohio State University College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christopher J Prusinski DO PAGroup PAC ID 0547345803, 2 clinicians

Practice addresses (Care Compare)

1310 W Eau Gallie Blvd
Suite B
Melbourne, FL 32935-5300
Phone (321) 421-6566

Hospital & facility affiliations

  • Holmes Regional Medical Center Hospital, Melbourne, FL, CCN 100019

Merit-based Incentive Payment System (MIPS)

Final score
83.86 of 100Reported as group
Quality
84.04
Improvement activities
40
Cost
67.48

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS0005640FLMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christopher J Prusinski DO PA Neurology CurrentSince Oct 5, 2007 Accepting new patients

Locations

1310 W Eau Gallie Blvd
Ste B
Melbourne, FL 32935
Phone (321) 421-6566

2404 N Courtenay Pkwy
#D
Merritt Island, FL 32953
Phone (321) 261-0055

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BJDJCD/Endpoint/BJDJCD
  • FHIR API: https://fhir4.healow.com/fhir/r4/BJDJCD

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1157673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187049600000",
    "number": "1467556779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 W EAU GALLIE BLVD",
            "address_2": "SUITE B",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329355300",
            "telephone_number": "321-421-6566",
            "fax_number": "321-421-6572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 W EAU GALLIE BLVD",
            "address_2": "SUITE B",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329355300",
            "telephone_number": "321-421-6566",
            "fax_number": "321-421-6572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUSINSKI",
        "first_name": "CHRISTOPHER",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-08",
        "last_updated": "2007-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "OS0005640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "80190",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.