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ATLANTIC MEDICAL GROUP
NPI 1144281247
Internal Medicine in West Melbourne, FL

Active since March 29, 2006CLIA 10D1081969 · Waiver
1541 S WICKHAM RD, WEST MELBOURNE, FL 32904(321) 726-6331(321) 726-6371 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Atlantic Medical Group NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ATLANTIC MEDICAL GROUP (NPI 1144281247) is a healthcare organization registered as an internal medicine in West Melbourne, Florida and active in the NPI registry since March 2006. The organization holds a CLIA Waiver certificate valid through February 20, 2028 and lists George Roque, President, as its authorized official.

NPPES Registry Identity

NPI1144281247
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameATLANTIC MEDICAL GROUP
Location Address1541 S WICKHAM RDWest Melbourne, FL 32904-3540
Mailing Address1541 S Wickham RdWest Melbourne, FL 32904-3540 · (321) 726-6331 · Fax (321) 726-6371
Phone(321) 726-6331
Fax(321) 726-6371
Organization SubpartNo
Authorized OfficialGeorge RoquePresident · (321) 726-6331
Enumeration DateMarch 29, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1144281247 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in FL · ME88828
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
1541 S WICKHAM RD, West Melbourne, FL 32904
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Other Identifiers 11

Other7274610Aetna Provider No.
Other246370Wellcare Mcaid Provider #
Other5585831Ccn Network Provider No.
OtherDD4702Railroad Mcare Group #
OtherP00022983Railroad Mcare Provider #
Other10024Floridiancare Provider #
Other1809978First Health Provider No.
Other9303692Cigna Provider No.
Other9362860Phcs Provider #
Other159351XXPreferred Care Provider #
Other37972Bcbs Provider Id

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Atlantic Medical Group is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Atlantic Medical Group, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

George Roque, M.D.
Internal Medicine
NPI 1376505834
1541 S WICKHAM RD
West Melbourne, FL 32904
(321) 726-6331
✔ PECOS✔ Accepts MedicareSame address
Elizabeth Ambrose
Nurse Practitioner
NPI 1043509300
1223 GATEWAY DR
Melbourne, FL 32901
(321) 312-3456
✔ PECOS✔ Accepts Medicare1.5 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D1081969

Atlantic Medical Group LLC · West Melbourne, FL
Active · expires Feb 20, 2028
CLIA Number10D1081969
Laboratory TypePhysician Office
Certificate Effective DateFebruary 21, 2026
Certificate Expiration DateFebruary 20, 2028
Laboratory DirectorGeorge E. Roque
Laboratory Phone(321) 726-6331
Laboratory LocationAtlantic Medical Group LLC1541 Wickham Rd, West Melbourne, FL 32904
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Atlantic Medical Group's NPI number?

The NPI number for Atlantic Medical Group is 1144281247. It was assigned to this organization in the NPPES registry on March 29, 2006.

Where is Atlantic Medical Group located?

Atlantic Medical Group is located at 1541 S Wickham Rd, West Melbourne, FL 32904. The listed phone number is (321) 726-6331.

What is Atlantic Medical Group's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Atlantic Medical Group enrolled in Medicare?

Yes. Atlantic Medical Group is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Atlantic Medical Group?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Atlantic Medical Group, in Internal Medicine and Nurse Practitioner. 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. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Atlantic Medical Group hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D1081969) is associated with this NPI, valid through February 20, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Atlantic Medical Group was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.