Brevard Psychiatry LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

BREVARD PSYCHIATRY LLC

Practice address

759 Glengarry Dr
Melbourne, FL 32940-1867

Phone

(801) 609-8388

Fax

(801) 797-0245

NPI assigned

Jun 2, 2022

Organization subpart

No

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

Authorized official

Name

Joseph SinNPI 1164866299

Title

President

Phone

(801) 609-8388

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Tax ID family

Brevard Psychiatry LLC2 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.

• Brevard Psychiatry LLC

  • Addiction Psychiatry Physician
  • Melbourne, FL
  • NPI 1669101861
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joseph Sin, M.D.

  • Psychiatry Physician
  • Melbourne, FL
  • NPI 1164866299
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1654128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661904000000",
    "number": "1730828286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "759 GLENGARRY DR",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329401867",
            "telephone_number": "801-609-8388",
            "fax_number": "801-797-0245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "759 GLENGARRY DR",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329401867",
            "telephone_number": "801-609-8388",
            "fax_number": "801-797-0245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREVARD PSYCHIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-02",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A",
        "authorized_official_last_name": "SIN",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-609-8388"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL MEDICARE",
            "identifier": "PF675",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brevard Physician Associates, PLLC
• Brevard Primary Care LLC
• Brevard Prosthetics & Orthotics, Inc
• Brevard Psychiatry & Psychology Inc
• Brevard Psychiatry LLC
• Brevard Psychological Associates, Inc
• Brevard Regional Hyperbaric Center
• Brevard Rheumatology & Arthritis Center
• Brevard Specialty Surgery Center LLC
• Brevard Surgery Center

• Psychiatry Physician in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; 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.