NPIMap

Organization Active NPI

Anesthesia Services of Brevard

  • Certified Registered Nurse Anesthetist
  • Melbourne, FL
National Provider Identifier
1720011877
Registry record updated Jan 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
ANESTHESIA SERVICES OF BREVARD
Practice address
315 E Nasa Blvd
Melbourne, FL 32901-1939
Phone
(321) 773-7303
Fax
(321) 773-7239
NPI assigned
Jul 9, 2006
Last updated
Jan 15, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2008

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

Authorized official

Name
Josephine M Macdonald, CRNANPI 1801970843
Title
President
Phone
(321) 243-9309

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X Primary

Addresses

Primary practice location

315 E Nasa Blvd
Melbourne, FL 32901-1939

Mailing address

PO Box 372311
Satellite Beach, FL 32937-0311
Phone (321) 773-7303

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060505000698 FL Part B Supplier - Clinic/Group Practice 3274544242 Receives reassigned benefits from 7 practitioners
Practice locations: Melbourne, FL; Titusville, FL

National Provider Directory

National Provider Directory

Locations

1995 W Nasa Blvd
Melbourne, FL 32904
Phone (321) 674-3912

2222 S Harbor City Blvd
Ste 540
Melbourne, FL 32901
Phone (321) 541-1776

4015 N Harbor City Blvd
#J
Melbourne, FL 32935
Phone (321) 821-6893

Practitioners & affiliated clinicians

Practitioners 7

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": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200355200000",
    "number": "1720011877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 372311",
            "city": "SATELLITE BEACH",
            "state": "FL",
            "postal_code": "329370311",
            "telephone_number": "321-773-7303",
            "fax_number": "321-773-7239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 E NASA BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329011939",
            "telephone_number": "321-773-7303",
            "fax_number": "321-773-7239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANESTHESIA SERVICES OF BREVARD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2008-01-15",
        "status": "A",
        "authorized_official_last_name": "MACDONALD",
        "authorized_official_first_name": "JOSEPHINE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-243-9309",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jan 15, 2008; 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.