Daniela E Rusovici, MD

Primary specialty

Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X

License

ME103609 Issued in FL

Practice address

5005 Port St John Pkwy
Suite 2200
Port St John, FL 32927-4305

Phone

(321) 633-8660

Fax

(321) 633-8617

NPI assigned

Dec 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• North Brevard Medical Support, Inc

  • Multi-Specialty Clinic/Center
  • Titusville, FL
  • NPI 1609834886
  Medicare reassignment NPD
• North Brevard Medical Support, Inc

  • Obstetrics & Gynecology Physician
  • Port St John, FL
  • NPI 1295409928
  NPD
• First Choice Medical Group of Brevard LLC

  • Orthopaedic Surgery Physician
  • Merritt Island, FL
  • NPI 1578846564
  NPD (past)

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423785600000",
    "number": "1801964788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7075 N US HIGHWAY 1",
            "address_2": "SUITE 150",
            "city": "PORT ST JOHN",
            "state": "FL",
            "postal_code": "329275216",
            "telephone_number": "321-268-6264",
            "fax_number": "321-633-8617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5005 PORT ST JOHN PKWY",
            "address_2": "SUITE 2200",
            "city": "PORT ST JOHN",
            "state": "FL",
            "postal_code": "329274305",
            "telephone_number": "321-633-8660",
            "fax_number": "321-633-8617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSOVICI",
        "first_name": "DANIELA",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2015-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "FL",
            "license": "ME103609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002534800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Flavia Lorena Ortiz
• Julio Merrel Pagan, MD
• Ravindran Balambal Palaniyandi, M.D.
• Parrish Medical Center
• Deanna Lynn Pichler, PA-C
• Sarah Maria Sampson Crandall, FNP
• David A Schafer, MD
• Penelope Constance Scott, LMT
• Saminder Singh, M.D.
• Patrick Sneed II

• Clinical Neurophysiology Physician in Port St John, FL
• Providers in Port St John, FL by specialty
• Clinical Neurophysiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.