SPACE COAST SURGERY CENTER LLC
NPI 1164662912
Clinic/Center - Ambulatory Surgical in Merritt Island, FL

NPI Status: Active since March 05, 2009

Contact Information

595 N COURTENAY PKWY
103
MERRITT ISLAND, FL
ZIP 32953
Phone: (813) 569-6500

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  • Organization
  • Clinic/Center
  • Ambulatory Surgical
  • Accepts Insurance
  • CLIA Number: 10D1097649
  • CLIA Cert. Type: Ambulatory Surgery Center
  • CLIA Exp. Date: 03-30-2027

About SPACE COAST SURGERY CENTER LLC

This page provides the complete NPI Profile along with additional information for Space Coast Surgery Center Llc, a provider established in Merritt Island, Florida operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1164662912 assigned on March 2009. The practitioner's primary taxonomy code is 261QA1903X. The provider is registered as an organization and their NPI record was last updated 4 years ago. The authorized official of this NPI record is Jennifer B Baldock (Officer And Authorized Official)

NPI
1164662912
Provider Name
SPACE COAST SURGERY CENTER LLC
Entity Type
Organization
Location Address
595 N COURTENAY PKWY 103 MERRITT ISLAND, FL 32953
Location Phone
(813) 569-6500
Mailing Address
595 N COURTENAY PKWY STE 103 MERRITT ISLAND, FL 32953
Mailing Phone
(813) 890-1800
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
03-05-2009
Last Update Date
11-01-2022
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Location Map

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

Clinic/Center Ambulatory Surgical

Taxonomy Code
261QA1903X
Type
Ambulatory Health Care Facilities

Insurance Plans Accepted

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

  • Complete VALUE Gold - HMO
  • Focused VALUE Silver - HMO
  • Focused VALUE Silver + Vision + Adult Dental - HMO
  • Standard Gold VALUE - HMO
  • Standard Silver VALUE - HMO
  • Standard Silver VALUE + Vision + Adult Dental - HMO
  • Clarity Silver - HMO
  • Clarity VALUE Silver - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete VALUE Gold - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite VALUE Bronze - HMO
  • Enhanced Diabetes Care Silver with $0 Drug Options - HMO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - HMO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • 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
  • 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
  • Gym Access IND Bronze HMO 1340 - HMO
  • Gym Access IND Bronze HMO OA 1211 - HMO
  • Gym Access IND Bronze HMO OA Standard 2450 - HMO
  • Gym Access IND Bronze POS 1042 - POS
  • Gym Access IND Bronze POS BC 3841 - POS
  • Gym Access IND Bronze POS OA 1211 - POS
  • Gym Access IND Bronze POS OA Standard 2450 - POS
  • Gym Access IND Bronze Standardized HMO - HMO
  • Gym Access IND Gold HMO 4500 - HMO
  • Gym Access IND Gold HMO BC 5651 - HMO
  • Bronze 1826 ($0 Medical Deductible, $0 Primary Care Copay- Visits 1 & 2, Specialist & Urgent Care Copay, Open Access) - HMO
  • Bronze 1826 + Adult Dental + Adult Vision ($0 Medical Deductible, $0 Primary Care Copay- Visits 1 & 2, Specialist & Urgent Care Copay, Open Access) - HMO
  • Bronze Savings 1820 (Primary Care Copay Visits 1-5, Open Access) - HMO
  • Bronze Savings 1820 + Adult Dental + Adult Vision (Primary Care Copay Visits 1-5, Open Access) - HMO
  • Bronze Standard 1828 - HMO
  • Bronze Value 1814 (High Value Network Savings, Open Access) - HMO
  • Bronze Value 1814 + Adult Dental + Adult Vision (High Value Network Savings, Open Access) - HMO
  • Catastrophic 1746 (Primary Care Copay Visits 1-3, Open Access) - HMO
  • Gold 1742 (Emergency Room & Inpatient Hospitalization Copay, $0 Outpatient Labs, $0 MRI, Open Access) - HMO
  • Gold 1742 + Adult Dental + Adult Vision (Emergency Room & Inpatient Hospitalization Copay, $0 Outpatient Labs, $0 MRI, Open Access) - HMO
  • Bronze Classic 4700 - HMO
  • Bronze Classic 4700 | with AdventHealth - HMO
  • Bronze Classic Standard - HMO
  • Bronze Classic Standard | with AdventHealth - HMO
  • Bronze Elite + PCP Saver Plus - HMO
  • Bronze Elite + PCP Saver Plus | with AdventHealth - HMO
  • Bronze Simple Breathe Easy with Enhanced COPD Benefits - HMO
  • Bronze Simple Chronic Care CKM - HMO
  • Bronze Simple Diabetes - HMO
  • Gold Classic Standard - HMO
  • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care) - HMO
  • UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision) - HMO
  • UHC Bronze Essential ($0 Virtual Urgent Care) - HMO
  • UHC Bronze Essential- ($0 Virtual Urgent Care) - HMO
  • UHC Bronze Standard - HMO
  • UHC Bronze Standard+ (Dental + Vision) - HMO
  • UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx) - HMO
  • UHC Gold Advantage+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision) - HMO
  • UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx) - HMO
  • UHC Gold Standard - HMO

*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

JENNIFER B BALDOCK

Authorized Official Title
OFFICER AND AUTHORIZED OFFICIAL
Authorized Official Phone
(615) 234-5954

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Aspiration and/or injection of fluid from large joint

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

This service was performed 20 times for 14 patients

Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint

This procedure involves using imaging guidance to accurately target and destroy nerves in the lower or sacral spinal facet joint. It's done to relieve chronic back pain. The process is safe and usually effective.

This service was performed 304 times for 149 patients

Destruction of nerve branches of knee using imaging guidance

This procedure involves the use of imaging technology to accurately locate and destroy specific nerve branches in the knee. This can help reduce chronic knee pain. The procedure is minimally invasive and usually performed under local anesthesia.

This service was performed 34 times for 21 patients

Destruction of nerves supplying joint between spine and pelvis using imaging guidance

This procedure involves the use of imaging technology to accurately locate and destroy specific nerves in the joint between your spine and pelvis. The goal is to reduce pain by interrupting the nerve signals responsible for your discomfort.

This service was performed 107 times for 65 patients

Destruction of peripheral nerve or branch

Destruction of a peripheral nerve or branch is a procedure to treat nerve-related pain. It involves using heat, cold, or chemicals to damage or destroy the nerve, thereby blocking pain signals to the brain. This can provide long-term pain relief.

This service was performed 18 times for 13 patients

Destruction of upper or middle spinal facet joint nerves using imaging guidance, single facet joint

This procedure involves the use of imaging technology to guide a needle to the nerves of a single facet joint in the upper or middle spine. The nerves are then treated to alleviate pain and improve mobility.

This service was performed 88 times for 47 patients

Heat destruction of intraosseous basivertebral nerve in bones of spine in lower back, first two bones

This procedure involves the use of heat to disable the basivertebral nerve within the first two bones of your lower spine. It's done to alleviate chronic lower back pain. It's a safe, minimally invasive procedure with a quick recovery time.

This service was performed 12 times for 12 patients

Injection of anesthetic agent and/or steroid into knee nerve branch using imaging guidance

This procedure involves injecting anesthetic and/or steroid medication into a knee nerve branch. Imaging technology is used to ensure accurate placement of the needle. This can help reduce pain and inflammation in the knee area.

This service was performed 22 times for 15 patients

Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level

This procedure involves injecting a mix of numbing and anti-inflammatory medication into a specific nerve root in the lower back. It helps manage pain and reduce inflammation. The process is guided by imaging technology for precision.

This service was performed 437 times for 173 patients

Injection of lower or sacral spine facet joint using imaging guidance, single level

This procedure involves injecting medication into the facet joint in your lower back or sacral spine. It's done under imaging guidance to ensure accuracy. The aim is to alleviate pain and inflammation. It's a safe, often effective method for managing spinal discomfort.

This service was performed 412 times for 130 patients

Injection of substance into lower spine canal using imaging guidance

This procedure involves injecting a substance into your lower spine canal, guided by real-time images. It's done to diagnose or treat various conditions. You may feel slight discomfort, but it's generally safe and can provide valuable information for your treatment plan.

This service was performed 277 times for 134 patients

Injection of substance into middle or upper spine canal using imaging guidance

This procedure involves injecting a substance into your middle or upper spine canal. It's performed under imaging guidance to ensure accuracy. The substance can help diagnose or treat various conditions, providing relief from symptoms.

This service was performed 185 times for 94 patients

Injection of upper or middle spine facet joint using imaging guidance, single level

This procedure involves injecting medication into a joint in your upper or middle spine. It's performed under imaging guidance for precision. The aim is to reduce inflammation and pain. It's a single-level process, meaning one joint is treated at a time.

This service was performed 125 times for 51 patients

Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography

This procedure involves injecting medicine into the sacroiliac joint, located in the lower back. The aim is to reduce inflammation and pain. Anesthetic is used for immediate pain relief, while a steroid helps decrease inflammation over time. Arthrography, a type of imaging, may be used for precision.

This service was performed 260 times for 97 patients

Insertion of spinal neurostimulator electrode array through skin

This procedure involves placing a small device, called a neurostimulator electrode array, under your skin near your spine. It delivers mild electrical signals to your spinal cord, helping to manage chronic pain.

This service was performed 63 times for 20 patients

Insertion of spinal neurostimulator generator or receiver

The insertion of a spinal neurostimulator generator or receiver is a procedure to manage chronic pain. A small device is implanted under your skin, which sends mild electrical signals to your spinal cord. These signals disrupt pain signals, helping to reduce discomfort.

This service was performed 22 times for 22 patients

Placement of stabilizing device to lower spine level

The placement of a stabilizing device to the lower spine level is a procedure aimed at providing support to your back. It involves positioning a device in your lower spine to help maintain its alignment and stability, reducing pain and improving mobility.

This service was performed 11 times for 11 patients

Removal of bone from lower spine for decompression of nerve tissue using imaging guidance, accessed through the skin

This procedure involves removing a small portion of bone from your lower spine. The goal is to relieve pressure on your nerve tissue, improving comfort and mobility. It is done through the skin using imaging technology to ensure precision and safety.

This service was performed 137 times for 134 patients

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
10D1097649
Facility Type
Ambulatory Surgery Center
Certificate Effective Date
March 31, 2025
Certificate Expiration Date
March 30, 2027
Laboratory Director
ASHISH UDESHI
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Space Coast Surgery Center Llc 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 1164662912, 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
1
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
4
Unchanged
Pos 5
6
Doubled → 12 → 1 + 2
Pos 6
6
Unchanged
Pos 7
2
Doubled → 4
Pos 8
9
Unchanged
Pos 9
1
Doubled → 2
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 6 → 12 → 3 6 → 12 → 3 2 → 4 1 → 2

Step 2: Add all digits plus the NPI constant

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

2 + 1 + 1 + 2 + 4 + 1 + 2 + 6 + 4 + 9 + 2 + 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 1164662912.

Other Providers at the Same Location


The following 18 providers are registered at the same or a nearby location.

Family Medicine
595 N COURTENAY PKWY, SUITE 102
MERRITT ISLAND, FL 32953
Physical Therapist
595 N COURTENAY PKWY, #203
MERRITT ISLAND, FL 32953
Physical Therapist
595 N COURTENAY PKWY, #203
MERRITT ISLAND, FL 32953
Physical Therapist
595 N COURTENAY PKWY, #203
MERRITT ISLAND, FL 32953
Speech-Language Pathologist
595 N COURTENAY PKWY, #203
MERRITT ISLAND, FL 32953
Physical Therapist
595 N COURTENAY PKWY, # 203
MERRITT ISLAND, FL 32953
Physical Therapist
595 N COURTENAY PKWY, #203
MERRITT ISLAND, FL 32953
Family Medicine
595 N COURTENAY PKWY, SUITE 102
MERRITT ISLAND, FL 32953
Physical Therapist
595 N COURTENAY PKWY, #203
MERRITT ISLAND, FL 32953
Non-Pharmacy Dispensing Site
595 N COURTENAY PKWY
MERRITT ISLAND, FL 32953
Physical Therapist
595 N COURTENAY PKWY, SUITE 203
MERRITT ISLAND, FL 32953
Massage Therapist
595 N COURTENAY PKWY, #203
MERRITT ISLAND, FL 32953
Physical Therapist
595 N COURTENAY PKWY, #203
MERRITT ISLAND, FL 32953
Pain Medicine (Interventional Pain Medicine)
595 N COURTENAY PKWY, STE. 101
MERRITT ISLAND, FL 32953
Pain Medicine (Interventional Pain Medicine)
595 N COURTENAY PKWY
MERRITT ISLAND, FL 32953
Pain Medicine (Interventional Pain Medicine)
595 N COURTENAY PKWY, SUITE 101
MERRITT ISLAND, FL 32953
Pediatrics
595 N COURTENAY PKWY, SUITE 204
MERRITT ISLAND, FL 32953
Anesthesiology
595 N COURTENAY PKWY, 103
MERRITT ISLAND, FL 32953

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1164662912, enumerated as an "organization" on March 05, 2009.

The provider is located at 595 N COURTENAY PKWY 103 MERRITT ISLAND, FL 32953 and the phone number is (813) 569-6500.

Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.

The provider might be accepting Accepts: Ambetter from Superior HealthPlan, Ambetter. Please consult your insurance carrier or call the provider to verify.