NPIMap

Organization Active NPI

Indian River Health Services Inc

  • Gynecology Physician
  • Vero Beach, FL
National Provider Identifier
1689112765
Registry record updated Sep 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
4029 Issued in FL
Legal business name
INDIAN RIVER HEALTH SERVICES INC
Practice address
3450 11TH CT
Suite 304
Vero Beach, FL 32960-5012
Phone
(772) 770-6801
Fax
(772) 770-6802
NPI assigned
Feb 8, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2019

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

Authorized official

Name
Mr. Jeffrey L Susi
Title
Ceo
Phone
(772) 567-4311

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VG0400X 4029 FL Primary

Addresses

Primary practice location

3450 11TH CT
Suite 304
Vero Beach, FL 32960-5012

Mailing address

PO Box 830270
MSC #375
Birmingham, AL 35283-0270
Phone (772) 567-4311

Other names 1

  • PREMIER WOMENS HEALTH Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070116000060 FL Part B Supplier - Clinic/Group Practice 9234130329 Receives reassigned benefits from 535 practitioners
39 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Vero Beach, FL; West Palm Beach, FL; Weston, FL; Hobe Sound, FL; Palm City, FL; Port Saint Lucie, FL; Sebastian, FL; Stuart, FL

Other NPIs on the same Medicare enrollment 39

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

View all 39

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1486512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568592000000",
    "number": "1689112765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 830270",
            "address_2": "MSC #375",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352830270",
            "telephone_number": "772-567-4311",
            "fax_number": "772-794-1450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 11TH CT",
            "address_2": "SUITE 304",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329605012",
            "telephone_number": "772-770-6801",
            "fax_number": "772-770-6802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIAN RIVER HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-08",
        "last_updated": "2019-09-16",
        "status": "A",
        "authorized_official_last_name": "SUSI",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "772-567-4311",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "FL",
            "license": "4029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PREMIER WOMENS HEALTH",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PREMIER WOMENS HEALTH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vero Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2019; 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.