NPIMap

Organization Active NPI

Neuroskeletal Imaging LLC

Doing business as Nsi Melbourne

  • Diagnostic Radiology Physician
  • Melbourne, FL
National Provider Identifier
1639163975
Registry record updated Apr 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
NEUROSKELETAL IMAGING LLC
Doing business as
Nsi Melbourne
Practice address
709 S Harbor City Blvd Ste 100
Melbourne, FL 32901-1936
Phone
(321) 409-9990
NPI assigned
Sep 1, 2005
Last updated
Apr 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2024

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

Authorized official

Name
Lisa Faucett
Title
Administrator
Phone
(321) 409-9990

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X
Diagnostic Radiology Physician 2085R0202X FL Primary

Addresses

Primary practice location

709 S Harbor City Blvd Ste 100
Melbourne, FL 32901-1936

Mailing address

PO Box 400
Melbourne, FL 32902-0400
Phone (321) 409-9990

Other identifiers 1

IdentifierTypeStateIssuer
274540200MedicaidFL

Other names 1

  • NSI MELBOURNE Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050810000711 FL Part B Supplier - Clinic/Group Practice 6204865223 Receives reassigned benefits from 9 practitioners
3 other NPIs on this enrollment
Practice locations: Melbourne, FL; Orlando, FL; Merritt Island, FL

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2008227Neuroskeletal Imaging Institute of Melbourne709 S Harbor City Blvd Suite 100, Melbourne, FL 32901Certificate of waiverJun 7, 2028

National Provider Directory

National Provider Directory
Tax ID family
Neuro Skeletal Imaging Inst Winter Park2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Networks

  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1125532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713830400000",
    "number": "1639163975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 400",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329020400",
            "telephone_number": "321-409-9990",
            "fax_number": "321-956-2165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 S HARBOR CITY BLVD STE 100",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329011936",
            "telephone_number": "321-409-9990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROSKELETAL IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-01",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A",
        "authorized_official_last_name": "FAUCETT",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "321-409-9990"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274540200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NSI MELBOURNE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NSI MELBOURNE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.