The Model Medical Group

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

THE MODEL MEDICAL GROUP

Practice address

333 W Cocoa Beach Cswy Ste D
Cocoa Beach, FL 32931-3513

Phone

(516) 384-1134

NPI assigned

Apr 23, 2019

Last updated

Apr 23, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Erica Monica Crew, MD

Title

Administrator

Phone

(516) 384-1134

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Jennifer Desouza, PH.D

  • Psychologist
  • Cocoa Beach, FL
  • NPI 1194471276
  NPD (past)

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

{
    "created_epoch": "1555977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555977600000",
    "number": "1891359162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2555 COX RD",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329263525",
            "telephone_number": "516-384-1134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 W COCOA BEACH CSWY STE D",
            "city": "COCOA BEACH",
            "state": "FL",
            "postal_code": "329313513",
            "telephone_number": "516-384-1134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MODEL MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-23",
        "last_updated": "2019-04-23",
        "status": "A",
        "authorized_official_last_name": "CREW",
        "authorized_official_first_name": "ERICA",
        "authorized_official_middle_name": "MONICA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "516-384-1134",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Cocoa Beach, FL
• Providers in Cocoa Beach, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.