NPIMap

Organization Active NPI

Steward Medical Group, Inc

  • Diagnostic Ultrasound Physician
  • Melbourne, FL
National Provider Identifier
1972073716
Registry record updated Dec 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Ultrasound PhysicianTaxonomy code 2085U0001X
Legal business name
STEWARD MEDICAL GROUP, INC
Practice address
250 N Wickham Rd
Melbourne, FL 32935-8625
Phone
(321) 752-1200
NPI assigned
Dec 4, 2018
Last updated
Dec 4, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
STEWARD HEALTH CARE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 4, 2018

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

Authorized official

Name
Mark D Pearlmutter, MDNPI 1073699625
Title
Chief of Emergency Medicine
Phone
(617) 789-2639

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Ultrasound PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085U0001X Primary

Addresses

Primary practice location

250 N Wickham Rd
Melbourne, FL 32935-8625

Mailing address

9 Galen St
Watertown, MA 02472-4515

Other practice location 1

13695 US Highway 1
Sebastian, FL 32958-3230
Phone (111) 111-1111

Other names 2

  • Florida Radiology Other name
  • Radiology - FL Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170602001215 FL Part B Supplier - Clinic/Group Practice 2860688728 Receives reassigned benefits from 277 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Steward Medical Group Inc60 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

7227 N US Highway 1
Ste 200
Cocoa, FL 32927
Phone (321) 255-8080

13695 US Highway 1
Sebastian, FL 32958
Phone (772) 589-3185

Practitioners & affiliated clinicians

Practitioners 48

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 48

NPI Registry JSON

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

{
    "created_epoch": "1543881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543881600000",
    "number": "1972073716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 GALEN ST",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024724515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 N WICKHAM RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329358625",
            "telephone_number": "321-752-1200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13695 US Highway 1",
            "address_purpose": "LOCATION",
            "city": "Sebastian",
            "state": "FL",
            "postal_code": "329583230",
            "country_code": "US",
            "telephone_number": "111-111-1111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "STEWARD MEDICAL GROUP, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STEWARD HEALTH CARE, LLC",
        "enumeration_date": "2018-12-04",
        "last_updated": "2018-12-04",
        "status": "A",
        "authorized_official_last_name": "PEARLMUTTER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CHIEF OF EMERGENCY MEDICINE",
        "authorized_official_telephone_number": "617-789-2639",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085U0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Florida Radiology",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Radiology - FL",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Dec 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.