NORTH BREVARD MEDICAL SUPPORT, INC
NPI 1073287702
Radiology - Diagnostic Radiology in Titusville, FL

NPI Status: Active since August 05, 2021

Contact Information

250 HARRISON ST STE 100
TITUSVILLE, FL
ZIP 32780
Phone: (321) 268-6674
Fax: (321) 268-6138

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  • Organization
  • Radiology
  • Diagnostic Radiology
  • Accepts Insurance
  • CLIA Number: 10D2123292
  • CLIA Cert. Type: End Stage Renal Disease Dialysis Facility
  • CLIA Exp. Date: 12-15-2026

About NORTH BREVARD MEDICAL SUPPORT, INC

This page provides the complete NPI Profile along with additional information for North Brevard Medical Support, Inc, a provider established in Titusville, Florida operating as a Radiology, focusing in diagnostic radiology . The healthcare provider is registered in the NPI registry with number 1073287702 assigned on August 2021. The practitioner's primary taxonomy code is 2085R0202X. The provider is registered as an organization and their NPI record was last updated 5 years ago. North Brevard Medical Support, Inc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Kent Andrew Bailey (Vp Finance)

NPI
1073287702
Provider Name
NORTH BREVARD MEDICAL SUPPORT, INC
Entity Type
Organization
Location Address
250 HARRISON ST STE 100 TITUSVILLE, FL 32780
Location Phone
(321) 268-6674
Location Fax
(321) 268-6138
Mailing Address
805 CENTURY MEDICAL DR STE C TITUSVILLE, FL 32796
Mailing Phone
(212) 686-2643
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
08-05-2021
Last Update Date
08-05-2021
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Radiology Diagnostic Radiology

Taxonomy Code
2085R0202X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1174400000XOther Service Providers

Specialist

 
2207X00000XAllopathic & Osteopathic Physicians

Orthopaedic Surgery

 
3261Q00000XAmbulatory Health Care Facilities

Clinic/Center

 

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • BlueOptions Bronze (HSA) 24J01-10 (Rewards / $4 Condition Care Rx) - PPO
  • BlueOptions Bronze 24J01-04 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - PPO
  • BlueOptions Bronze 24J01-06 (Rewards) - PPO
  • BlueOptions Bronze 24J01-17 ($50 PCP Visits / Rewards) - PPO
  • BlueOptions Bronze 24J01-18S ($50 PCP Visits / Rewards) - PPO
  • BlueOptions Gold 24J01-09 ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Rewards) - PPO
  • BlueOptions Gold 24J01-12 ($40 PCP Visits / $75 Specialist Visits / $15 Labs / Rewards) - PPO
  • BlueOptions Gold 24J01-20S ($30 PCP Visits / $60 Specialist Visits / Rewards) - PPO
  • BlueOptions Platinum 24J01-05 ($0 Labs / $15 PCP Visits / $35 Specialist Visits / Rewards) - PPO
  • BlueOptions Platinum 24J01-08 ($0 Deductible / $0 Labs / $15 PCP Visits / $25 Specialist Visits / Rewards) - PPO
  • BlueOptions Platinum 24J01-21S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Rewards) - PPO
  • BlueOptions Silver 24J01-03 ($10 Labs / Rewards) - PPO
  • BlueOptions Silver 24J01-07 ($50 PCP Visits / Rewards) - PPO
  • BlueOptions Silver 24J01-19S ($40 PCP Visits / $80 Specialist Visits / Rewards) - PPO
  • BlueSelect Bronze (HSA) 1735 (Rewards / $4 Condition Care Rx) - EPO
  • BlueSelect Bronze 1449 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - EPO
  • BlueSelect Bronze 2139 ($50 PCP Visits / Rewards) - EPO
  • BlueSelect Bronze 2139E ($50 PCP Visits / Adult Dental & Vision / Rewards) - EPO
  • BlueSelect Bronze 2139V ($50 PCP Visits / Adult Vision / Rewards) - EPO
  • BlueSelect Bronze 2342S ($50 PCP Visits / Rewards) - EPO
  • BlueCare Bronze (HSA) 24K01-09 (Rewards / $4 Condition Care Rx) - POS
  • BlueCare Bronze 24K01-03 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - POS
  • BlueCare Bronze 24K01-05 (Rewards) - POS
  • BlueCare Bronze 24K01-25 ($50 PCP Visits / $75 Specialist Visits / Rewards) - POS
  • BlueCare Bronze 24K01-31S ($50 PCP Visits / Rewards) - POS
  • BlueCare Bronze 24K02-17 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - POS
  • BlueCare Bronze 24K02-18 (Rewards) - POS
  • BlueCare Bronze 24K02-23 ($50 PCP Visits / $75 Specialist Visits / Rewards) - POS
  • BlueCare Bronze 24K02-26S ($50 PCP Visits / Rewards) - POS
  • BlueCare Gold 24K01-08 ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Rewards) - POS
  • BlueCare Gold 24K01-10 ($40 PCP Visits / $75 Specialist Visits / $15 Labs / Rewards) - POS
  • BlueCare Gold 24K01-33S ($30 PCP Visits / $60 Specialist Visits / Rewards) - POS
  • BlueCare Gold 24K02-20 ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Rewards) - POS
  • BlueCare Gold 24K02-28S ($30 PCP Visits / $60 Specialist Visits / Rewards) - POS
  • BlueCare Platinum 24K01-04 ($0 Labs / $15 PCP Visits / $35 Specialist Visits / Rewards) - POS
  • BlueCare Platinum 24K01-07 ($0 Deductible / $0 Labs / $15 PCP Visits / $25 Specialist Visits / Rewards) - POS
  • BlueCare Platinum 24K01-34S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Rewards) - POS
  • BlueCare Platinum 24K02-15 ($0 Deductible / $0 Labs / $15 PCP Visits / $25 Specialist Visits / Rewards) - POS
  • BlueCare Platinum 24K02-29S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Rewards) - POS
  • BlueCare Silver 24K01-02 ($10 Labs / Rewards) - POS

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

KENT ANDREW BAILEY

Authorized Official Title
VP FINANCE
Authorized Official Phone
(321) 268-6111

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
10D2123292
Facility Type
End Stage Renal Disease Dialysis Facility
Certificate Effective Date
December 16, 2024
Certificate Expiration Date
December 15, 2026
Laboratory Director
IMRAN RASHID
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to North Brevard Medical Support, Inc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1073287702, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
3
Unchanged
Pos 5
2
Doubled → 4
Pos 6
8
Unchanged
Pos 7
7
Doubled → 14 → 1 + 4
Pos 8
7
Unchanged
Pos 9
0
Doubled → 0
Check
2
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 7 → 14 → 5 2 → 4 7 → 14 → 5 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 1 + 4 + 3 + 4 + 8 + 1 + 4 + 7 + 0 + 24 = 58

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 58 is 60. The difference is the calculated check digit.

60 - 58 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1073287702.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1073287702, enumerated as an "organization" on August 05, 2021.

The provider is located at 250 HARRISON ST STE 100 TITUSVILLE, FL 32780 and the phone number is (321) 268-6674.

Radiology with taxonomy code 2085R0202X and a focus in Diagnostic Radiology.

The provider might be accepting Accepts: Florida Blue (BlueCross BlueShield FL) and Florida. Please consult your insurance carrier or call the provider to verify.