Mark R Licht
NORTH BREVARD MEDICAL SUPPORT INC


Address: 825 Century Medical Dr, Titusville, FL 32796-2113
Phone: 3215674991

Mark R Licht (NPI# 1306841473, PAC ID# 6800999293) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is UROLOGY.

Physician Overview

Nation Provider ID (NPI) 1306841473
PAC ID by PECOS 6800999293
Professional Enrollment ID I20070305000499
Full Name Mark R Licht
Organization Legal Name NORTH BREVARD MEDICAL SUPPORT INC
Address 825 Century Medical Dr
Titusville
FL 32796-2113
Phone Number 3215674991
Gender M
Credential MD
Medical School UNIVERSITY OF ROCHESTER SCHOOL OF MEDICINE AND DENTISTRY
Graduation Year 1988
Primary Specialty UROLOGY
Group Practice PAC ID 7618870296
Number of Group Practice Members 59
Accepts Medicare Assignment Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
100028 PARRISH MEDICAL CENTER

Other Locations

Address Phone Organization
825 Century Medical Dr, Titusville, FL 32796-2113 3215674991 NORTH BREVARD MEDICAL SUPPORT INC

Individual EP (Eligible Professionals) Public Reporting – Performance Scores
Physician Quality Reporting System (PQRS) and non-PQRS Qualified Clinical Data Registry (QCDR)

Measure Identifier Measure Title Performance Rate Reporting Mechanism
ACI_EC_TRANS_PHCDRR_3 Specialized Registry Reporting %
ACI_EC_TRANS_PHCDRR_3 Specialized Registry Reporting %
ACI_EC_TRANS_PPHI_1 Security Risk Analysis %
ACI_EC_TRANS_PPHI_1 Security Risk Analysis %
MIPS_EC_047_overall Care Plan 6%
MIPS_EC_047_overall Care Plan 6%
MIPS_EC_238_2+ Use of High-Risk Medications in the Elderly (100%: worst, 0% best) 0%
MIPS_EC_238_2+ Use of High-Risk Medications in the Elderly (100%: worst, 0% best) 0%
MIPS_EC_238_overall Use of High-Risk Medications in the Elderly (100%: worst, 0% best) 0%
MIPS_EC_238_overall Use of High-Risk Medications in the Elderly (100%: worst, 0% best) 0%

Organization Information

Organization Legal Name NORTH BREVARD MEDICAL SUPPORT INC
Physicians 51

Physicians with the same organization

Name Specialty Organization Address
Khalid George Gastroenterology North Brevard Medical Support Inc 825 Century Medical Dr, Titusville, FL 32796-2113
Dixitkumar Modi Family Medicine North Brevard Medical Support Inc 390 Challenger Rd, Cape Canaveral, FL 32920-4200
Rachel M Loeffler Nurse Practitioner North Brevard Medical Support Inc 5005 Port St John Pkwy, Suite 2400, Port St John, FL 32927-4305
Cara Starkey Certified Nurse Midwife (cnm) North Brevard Medical Support Inc 494 N Washington Ave, Titusville, FL 32796-2871
Pamela S Tronetti Geriatric Medicine North Brevard Medical Support Inc 805 Century Medical Dr A, Titusville, FL 32796-2100
Vidya N Hate Obstetrics/gynecology North Brevard Medical Support Inc 250 Harrison St, Titusville, FL 32780-5026
Patricia A Alexander Family Medicine North Brevard Medical Support Inc 250 Harrison St, Titusville, FL 32780-5026
Dawn Hillebrandt Nurse Practitioner North Brevard Medical Support Inc 250 Harrison St, Titusville, FL 32780-5026
Arvind D'cruz Neurology North Brevard Medical Support Inc 951 N Washington Ave, Titusville, FL 32796-2159
Benjamin Nettleton Family Medicine North Brevard Medical Support Inc 951 N Washington Ave, Titusville, FL 32796-2163

Office Location

Street Address 825 CENTURY MEDICAL DR
City TITUSVILLE
State FL
Zip 32796-2113

Physicians in the same location

Name Specialty Organization Address
Khalid George Gastroenterology North Brevard Medical Support Inc 825 Century Medical Dr, Titusville, FL 32796-2113
Sherry L Riley Nurse Practitioner North Brevard Medical Support Inc 825 Century Medical Dr, Titusville, FL 32796-2113

Physicians in the same zip code

Name Specialty Organization Address
Sarah Slone Nurse Practitioner Moore Medical Group Inc 2355 Truman Scarborough Way, Palm Point Behavioral Health, Titusville, FL 32796-1310
Eric A Moore Family Medicine Moore Medical Group Inc 2355 Truman Scarborough Way, Palm Point Behavioral Health, Titusville, FL 32796-1310
Mayra A Abelleira Martinez Psychiatry 2355 Truman Scarborough Way, Attn Cfo, Titusville, FL 32796-1310
Ismael A Beloso Family Medicine Moore Medical Group Inc 2355 Truman Scarborough Way, Palm Point Behavioral Health, Titusville, FL 32796-1310
Charles Ikegwuonu Nurse Practitioner Moore Medical Group Inc 2355 Truman Scarborough Way, Palm Point Behavioral Health, Titusville, FL 32796-1310
Laura Kn Powell Nurse Practitioner Moore Medical Group Inc 2355 Truman Scarborough Way, Palm Point Behavioral Health, Titusville, FL 32796-1310
Debra Kay Allen Nurse Practitioner Indian River Medical Office Pa 3300 Dairy Rd, Titusville, FL 32796-1512
Aluino L Ochoa Internal Medicine Indian River Medical Office Pa 3300 Dairy Rd, Titusville, FL 32796-1512
Cheryl M Gardner Nurse Practitioner Indian River Medical Office Pa 3300 Dairy Rd, Titusville, FL 32796-1512
Kimberly E Lundquist Nurse Practitioner Indian River Medical Office Pa 3300 Dairy Rd, Titusville, FL 32796-1512
Find all physicians in zip 32796

Competitor

Search similar physicians

City TITUSVILLE
Zip Code 32796
Specialty UROLOGY
City + Specialty TITUSVILLE + UROLOGY

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS)
Jurisdiction Medicare

This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.

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