NPIMap

Organization Active NPI

Indian River Health Services Inc

  • Pediatrics Physician
  • Vero Beach, FL
National Provider Identifier
1992083794
Registry record updated Jul 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME78560 Issued in FL
Legal business name
INDIAN RIVER HEALTH SERVICES INC
Practice address
1000 36TH St
Suite 2105
Vero Beach, FL 32960-4862
Phone
(772) 567-4311
Fax
(772) 794-1450
NPI assigned
Jul 27, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2011

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

Authorized official

Name
Jeffrey L Susi
Title
President/Ceo
Phone
(772) 567-4311

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X ME78560 FL Primary

Addresses

Primary practice location

1000 36TH St
Suite 2105
Vero Beach, FL 32960-4862

Mailing address

1000 36TH St
Vero Beach, FL 32960-4862
Phone (772) 567-4311

Other names 1

  • IRHS-PEDIATRIC HOSPITALIST Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070116000060 FL Part B Supplier - Clinic/Group Practice 9234130329 Receives reassigned benefits from 535 practitioners
39 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Vero Beach, FL; West Palm Beach, FL; Weston, FL; Hobe Sound, FL; Palm City, FL; Port Saint Lucie, FL; Sebastian, FL; Stuart, FL

Other NPIs on the same Medicare enrollment 39

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

View all 39

National Provider Directory

National Provider Directory

Locations

1000 36th St
Ste 2105
Vero Beach, FL 32960

NPI Registry JSON

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

{
    "created_epoch": "1311724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311724800000",
    "number": "1992083794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 36TH ST",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329604862",
            "telephone_number": "772-567-4311",
            "fax_number": "772-794-1450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 36TH ST",
            "address_2": "SUITE 2105",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329604862",
            "telephone_number": "772-567-4311",
            "fax_number": "772-794-1450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIAN RIVER HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-27",
        "last_updated": "2011-07-27",
        "status": "A",
        "authorized_official_last_name": "SUSI",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "772-567-4311"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME78560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IRHS-PEDIATRIC HOSPITALIST",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vero Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2011; 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.