NECMO PA (NPI# 1619507209) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619507209 |
| Entity Type | Organization |
| Organization Name | NECMO PA |
| Practice Address |
250 N Wickham Rd Melbourne FL 32935-8625 |
| Mailing Address |
19710 Wild Water Cv Lutz FL 33559-7387 |
| Practice Telephone | 3217521331 |
| Enumeration Date | 2020-01-22 |
| Last Update Date | 2020-01-22 |
| Authorized Official Name | DR. BIJAN NIK MORADI (CEO) |
| Authorized Official Telephone | 2027135818 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
250 N WICKHAM RD |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32935-8625 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306848668 | Robert Bell | Emergency Medicine | 250 N Wickham Rd, Melbourne, FL 32935-8625 | 2005-06-01 |
| 1255898102 | Ronald Glen Gordon | Registered Nurse | 250 N Wickham Rd, Melbourne, FL 32935-8625 | 2019-02-27 |
| 1811461007 | Ann Maria Thomas | Nurse Practitioner | 250 N Wickham Rd, Melbourne, FL 32935-8625 | 2019-01-22 |
| 1972073716 | Steward Medical Group, Inc | Radiology | 250 N Wickham Rd, Melbourne, FL 32935-8625 | 2018-12-04 |
| 1437643640 | Caleb Quick | Nurse Practitioner | 250 N Wickham Rd, Melbourne, FL 32935-8625 | 2018-06-20 |
| 1538650940 | Lisa Collins Lancaster | Registered Nurse | 250 N Wickham Rd, Melbourne, FL 32935-8625 | 2018-05-21 |
| 1629565965 | Pietro Loesener | Nurse Practitioner | 250 N Wickham Rd, Melbourne, FL 32935-8625 | 2018-04-20 |
| 1215435870 | Khashaba LLC | Hospitalist | 250 N Wickham Rd, Melbourne, FL 32935-8625 | 2018-01-30 |
| 1790283661 | Dr Joseph D Paolucci Md Pa LLC | Hospitalist | 250 N Wickham Rd, Melbourne, FL 32935-8625 | 2018-01-25 |
| 1801320718 | Steward Melbourne Hospital, Inc. | General Acute Care Hospital | 250 N Wickham Rd, Melbourne, FL 32935-8625 | 2017-04-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407412018 | Aleecia Estime | Nurse Practitioner | 401 N Wickham Rd Ste S, Melbourne, FL 32935 | 2019-05-20 |
| 1669948261 | Lisa Marie Sarkees | Social Worker | 1503 Spring Drive, Melbourne, FL 32935 | 2018-10-22 |
| 1407355399 | Eugene Slaughter | Case Manager/Care Coordinator | 1600 W Eau Gallie Blvd. Suite 201 F, Melbourne, FL 32935 | 2018-02-06 |
| 1588173173 | Gregory M Mcdermand | Respiratory Therapist, Certified | 2745 Revolution St, Unit 101, Melbourne, FL 32935 | 2017-09-26 |
| 1386173649 | M Shami | Nurse Practitioner | 401 N Wickham Rd. Suite S, Melbourne, FL 32935 | 2017-06-08 |
| 1588102297 | Chiro Choice A Limited Liability Company | Clinic/Center | 1310 W Eau Galle Blvd Ste A, Melbourne, FL 32935 | 2017-02-02 |
| 1124574835 | A Loving Touch Private Home Care | Home Health | 1595 Palmwood Drive, Melbourne, FL 32935 | 2016-09-01 |
| 1538616099 | Pedro Triana Villamil | Specialist/Technologist, Other | 1600 Sarno Rd. Suite 15, Melbourne, FL 32935 | 2016-09-01 |
| 1528424132 | Lisa Forsythe | Acupuncturist | 1250 W. Eau Gallie Blvd., Suite H, Melbourne, FL 32935 | 2016-01-12 |
| 1528432028 | Harbor City Pharmacy Inc | Pharmacy | 503 Harbor City Blvd., Melbourne, FL 32935 | 2015-11-20 |
| Find all providers in zip 32935 | ||||
| Taxonomy Code | 207RC0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Critical Care Medicine |
| An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275826133 | Kerry Elizabeth Spero | Internal Medicine | 8725 N Wickham Rd Ste 203, Melbourne, FL 32940-2240 | 2011-05-25 |
| 1548293442 | Parvesh K. Bansal | Internal Medicine | 1400 Pine St, Suite A, Melbourne, FL 32901-3170 | 2006-07-07 |
| 1225396302 | Jonathan Torres-luna | Internal Medicine | 1223 Gateway Dr Ste 2g, Melbourne, FL 32901-2607 | 2012-04-26 |
| 1083900377 | Vanessa Joann Ohleyer | Internal Medicine | 8745 N Wickham Rd, Melbourne, FL 32940 | 2011-06-24 |
| 1972819944 | Anton Micael Dela Cruz | Internal Medicine | 1350 Hickory St, Melbourne, FL 32901-3224 | 2010-08-27 |
| 1932422433 | Rodel Umlas Banal | Internal Medicine | 1314 Oak St, Melbourne, FL 32901-3111 | 2010-03-11 |
| 1407976517 | Ashlee E. Moore | Internal Medicine | 1350 Hickory St, Melbourne, FL 32901 | 2007-03-30 |
| 1659392785 | Zaki Elmaghraby | Internal Medicine | 1314 Oak St, Melbourne, FL 32901-3111 | 2006-07-22 |
| 1841243920 | William Lemar Jackson Jr. | Internal Medicine | 1350 S Hickory St, Melbourne, FL 32901-3278 | 2006-05-18 |
| 1801859368 | James P Shaffer | Internal Medicine | 8725 N Wickham Rd, Suite 302, Melbourne, FL 32940-2239 | 2006-04-07 |
| Find all providers in MELBOURNE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.