Individual provider Active NPI

Christian Cameron Prusinski, DO

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Melbourne, FL
National Provider Identifier
1831693530
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084P2900X
License
OS16340 Issued in FL
Practice address
1310 W Eau Gallie Blvd Ste B
Melbourne, FL 32935-5300
Phone
(321) 421-6566
Fax
(321) 421-6572
NPI assigned
Mar 19, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X OS16340 FL
Pain Medicine (Psychiatry & Neurology) Physician 2084P2900X OS16340 FL Primary

Addresses

Primary practice location

1310 W Eau Gallie Blvd Ste B
Melbourne, FL 32935-5300

Mailing address

1310 W Eau Gallie Blvd Ste B
Melbourne, FL 32935-5300
Phone (321) 421-6566

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20220805003118 FL Practitioner - Pain Management 8729336532 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pain Management
Education
Nova Southeastern College of Osteo Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christopher J Prusinski DO PAGroup PAC ID 0547345803, 2 clinicians
H2 Rehabilitation Services of Florida LLCGroup PAC ID 3971411851, shared by 10 NPIs, 257 clinicians

Practice addresses (Care Compare)

1310 W Eau Gallie Blvd
Suite B
Melbourne, FL 32935-5300
Phone (321) 421-6566

2225 S Babcock St
Suite 110
Melbourne, FL 32901-5305
Phone (321) 425-4321

Hospital & facility affiliations

  • Cape Canaveral Hospital Hospital, Cocoa Beach, FL, CCN 100177

Merit-based Incentive Payment System (MIPS)

Final score
83.86 of 100Reported as group
Quality
84.04
Improvement activities
40
Cost
67.48

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS16340FLMDPain Medicine (Psychiatry & Neurology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Jacksonville CurrentSince Jul 1, 2022 Accepting new patients
Mayo Clinic Jacksonville CurrentSince Jul 1, 2022 Accepting new patients
Christopher J Prusinski DO PA Neurology CurrentSince Jul 1, 2023 Accepting new patients

Locations

4500 San Pablo Rd S
Jacksonville, FL 32224
Phone (904) 721-4815

1310 W Eau Gallie Blvd
Ste B
Melbourne, FL 32935
Phone (321) 421-6566

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BJDJCD

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1521417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1831693530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 W EAU GALLIE BLVD STE B",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329355300",
            "telephone_number": "321-421-6566",
            "fax_number": "321-421-6572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 W EAU GALLIE BLVD STE B",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329355300",
            "telephone_number": "321-421-6566",
            "fax_number": "321-421-6572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUSINSKI",
        "first_name": "CHRISTIAN",
        "middle_name": "CAMERON",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-19",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "OS16340",
            "primary": false
        },
        {
            "code": "2084P2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Pain Medicine",
            "state": "FL",
            "license": "OS16340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.