NPIMap

Organization Active NPI

Brain and Spine Clinic LLC

  • Neurological Surgery Physician
  • Melbourne, FL
National Provider Identifier
1962049163
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
BRAIN AND SPINE CLINIC LLC
Practice address
1428 Valentine St
Melbourne, FL 32901-3130
Phone
(321) 327-7797
Fax
(321) 327-7789
NPI assigned
Dec 6, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Authorized official

Name
Jacob Januszewski, DO
Title
Manager
Phone
(321) 327-7797

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X Primary

Addresses

Primary practice location

1428 Valentine St
Melbourne, FL 32901-3130

Mailing address

1428 Valentine St
Melbourne, FL 32901-3130
Phone (321) 327-7797

Other practice location 1

2065 Highway A1A Apt 1704
Indian Harbour Beach, FL 32937-1812
Phone (917) 502-1112

Other names 1

  • Brain and Spine Clinic Doing business as

National Provider Directory

National Provider Directory

Locations

4015 N Harbor City Blvd
Melbourne, FL 32935
Phone (321) 821-6893

1601 S Apollo Blvd
Ste C
Melbourne, FL 32901
Phone (321) 327-7789

2590 S Bumby Ave
Orlando, FL 32806
Phone (407) 454-9196

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1575590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756771200000",
    "number": "1962049163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1428 VALENTINE ST",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013130",
            "telephone_number": "321-327-7797",
            "fax_number": "321-327-7789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1428 VALENTINE ST",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013130",
            "telephone_number": "321-327-7797",
            "fax_number": "321-327-7789"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2065 Highway A1A Apt 1704",
            "address_purpose": "LOCATION",
            "city": "Indian Harbour Beach",
            "state": "FL",
            "postal_code": "329371812",
            "country_code": "US",
            "telephone_number": "917-502-1112",
            "fax_number": "844-895-3070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BRAIN AND SPINE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-06",
        "last_updated": "2025-09-02",
        "certification_date": "2024-08-06",
        "status": "A",
        "authorized_official_last_name": "JANUSZEWSKI",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "321-327-7797",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brain and Spine Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; 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.