NPIMap

Organization Active NPI

Adult & Child Counseling and Psychiatric Center, P.a.

  • Psychiatry Physician
  • Melbourne, FL
National Provider Identifier
1629034996
Registry record updated Apr 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME50534 Issued in FL
Legal business name
ADULT & CHILD COUNSELING AND PSYCHIATRIC CENTER, P.A.
Practice address
5545 N Wickham Rd
Suite 110
Melbourne, FL 32940-7323
Phone
(321) 779-9838
Fax
(321) 779-4502
NPI assigned
Apr 25, 2006
Last updated
Apr 17, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2014

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

Authorized official

Name
Dr. Vijaykumar R Bhujang, M.D.
Title
Ceo
Phone
(321) 779-9838

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Social Worker 104100000X SW3652 FL
Social Worker 104100000X SW3614 FL
Psychiatry Physician 2084P0800X ME40362 FL
Psychiatry Physician 2084P0800X ME50534 FL Primary

Addresses

Primary practice location

5545 N Wickham Rd
Suite 110
Melbourne, FL 32940-7323

Mailing address

5545 N Wickham Rd
Suite 110
Melbourne, FL 32940-7323
Phone (321) 779-9838

Other identifiers 1

IdentifierTypeStateIssuer
253817200MedicaidFL

Other names 1

  • Adult & Child Counseling & Psychiatric Center, P.A. Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101015000513 FL Part B Supplier - Clinic/Group Practice 0042403610 Receives reassigned benefits from 14 practitioners
Practice locations: Melbourne, FL

National Provider Directory

National Provider Directory

Locations

5545 N Wickham Rd
Melbourne, FL 32940
Phone (321) 779-9838

5545 N Wickham Rd
Ste 110
Melbourne, FL 32940
Phone (321) 452-5633

1275 South Patrick Dr
Ste C
Satellite Beach, FL 32937
Phone (321) 779-9838

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397692800000",
    "number": "1629034996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5545 N WICKHAM RD",
            "address_2": "SUITE 110",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329407323",
            "telephone_number": "321-779-9838",
            "fax_number": "321-779-4502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5545 N WICKHAM RD",
            "address_2": "SUITE 110",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329407323",
            "telephone_number": "321-779-9838",
            "fax_number": "321-779-4502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADULT & CHILD COUNSELING AND PSYCHIATRIC CENTER, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-25",
        "last_updated": "2014-04-17",
        "status": "A",
        "authorized_official_last_name": "BHUJANG",
        "authorized_official_first_name": "VIJAYKUMAR",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "321-779-9838",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "FL",
            "license": "SW3652",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "FL",
            "license": "SW3614",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME40362",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME50534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "253817200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Adult & Child Counseling & Psychiatric Center, P.A.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2014; 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.