EAST COAST NEURO LLC
NPI 1124424643
Psychiatry & Neurology - Neurology in Jacksonville, FL
About East Coast Neuro Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
EAST COAST NEURO LLC (NPI 1124424643), doing business as East Coast Injury Clinic, is a healthcare organization registered as a neurology in Jacksonville, Florida and active in the NPI registry since November 2014. The organization maintains a secondary practice location in Jacksonville and lists Vanessa Jaclyn Wilczak, Owner And Authorized Official, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 4
Other Names 1
Secondary Practice Location 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
East Coast Neuro Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
10Medicare enrollment records show 10 clinicians reassign Medicare billing to East Coast Neuro LLC, which bills Medicare for the services they deliver. Of these, 8 practice within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 6
Clinicians, nearest first (10)
Jacksonville, FL 32256
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is East Coast Neuro LLC's NPI number?
The NPI number for East Coast Neuro LLC is 1124424643. It was assigned to this organization in the NPPES registry on November 11, 2014. The provider is doing business as East Coast Injury Clinic.
Where is East Coast Neuro LLC located?
East Coast Neuro LLC is located at 10550 Deerwood Park Blvd Ste 609A, Jacksonville, FL 32256. The listed phone number is (904) 513-3954.
What is East Coast Neuro LLC's specialty?
The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.
Is East Coast Neuro LLC enrolled in Medicare?
Yes. East Coast Neuro LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through East Coast Neuro LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 10 clinicians in 6 Medicare specialties reassign their Medicare billing to East Coast Neuro LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Physical Therapist in Private Practice (3), Chiropractic (2) and Nurse Practitioner (2). Of these, 8 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for East Coast Neuro LLC was last updated on January 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# East Coast Neuro Llc · NPI 1124424643
Neurology organization in Jacksonville, Florida. Organization record, active in the CMS NPPES registry since November 11, 2014.
## Identity
- **NPI:** 1124424643 (Entity type: Organization)
- **Enumerated:** November 11, 2014
- **Primary specialty:** Psychiatry & Neurology - Neurology · taxonomy 2084N0400X
- **Also known as:** East Coast Injury Clinic (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Vanessa Wilczak, OWNER AND AUTHORIZED OFFICIAL
## Practice location
- **Address:** 10550 DEERWOOD PARK BLVD STE 609A, Jacksonville, FL 32256-2811
- **Phone:** (904) 513-3954 · **Fax:** (904) 212-0223
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 10 clinicians in 6 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Physical Therapist in Private Practice (3), Chiropractic (2), Nurse Practitioner (2); 8 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 22, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1124424643) · Data from the CMS NPPES public registry.