Organization Active NPI

Medical Partners of Florida LLC

  • Neurological Surgery Physician
  • Titusville, FL
National Provider Identifier
1821575960
Registry record updated Apr 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
MEDICAL PARTNERS OF FLORIDA LLC
Practice address
3910 S Washington Ave Ste 109
Titusville, FL 32780-5860
Phone
(321) 267-0188
NPI assigned
Jul 22, 2018
Last updated
Apr 7, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2020

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

Authorized official

Name
Armen Deukmedjian, MDNPI 1760670889
Title
Provider
Phone
(813) 997-2099

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU
Neurological Surgery Physician 207T00000X NU Primary

Addresses

Primary practice location

3910 S Washington Ave Ste 109
Titusville, FL 32780-5860

Mailing address

1861 S Patrick Dr Ste 137
Indian Harbour Beach, FL 32937-4377

Other practice location 1

8043 Spyglass Hill Rd Ste 102
Melbourne, FL 32940-8563
Phone (321) 757-6899

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200414003304 FL Part B Supplier - Clinic/Group Practice 6901236983 Receives reassigned benefits from 6 practitioners
Practice locations: Melbourne, FL

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
10D2270035Medical Partners of Florida, LLC8043 Spyglass Hill Road, Ste 102, Melbourne, FL 32940Certificate of waiverOct 6, 2026

National Provider Directory

National Provider Directory

Locations

8043 Spyglass Hill Rd
Ste 102
Melbourne, FL 32940
Phone (321) 755-6899

Practitioners & affiliated clinicians

Practitioners 21

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.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1532217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586217600000",
    "number": "1821575960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1861 S PATRICK DR STE 137",
            "city": "INDIAN HARBOUR BEACH",
            "state": "FL",
            "postal_code": "329374377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3910 S WASHINGTON AVE STE 109",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327805860",
            "telephone_number": "321-267-0188"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8043 Spyglass Hill Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329408563",
            "country_code": "US",
            "telephone_number": "321-757-6899",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MEDICAL PARTNERS OF FLORIDA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-22",
        "last_updated": "2020-04-07",
        "certification_date": "2020-04-07",
        "status": "A",
        "authorized_official_last_name": "DEUKMEDJIAN",
        "authorized_official_first_name": "ARMEN",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "813-997-2099",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Titusville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2020; 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.