INDIAN RIVER MEDICAL OFFICE PA
NPI 1245220557
Specialist in Titusville, FL
About Indian River Medical Office Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
INDIAN RIVER MEDICAL OFFICE PA (NPI 1245220557) is a healthcare organization registered as a specialist in Titusville, Florida and active in the NPI registry since October 2005. The organization holds a CLIA Waiver certificate valid through April 1, 2028 and lists Jill D Whittamore, Administrator, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 3
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Indian River Medical Office Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
4Medicare enrollment records show 4 clinicians reassign Medicare billing to Indian River Medical Office PA, which bills Medicare for the services they deliver. Of these, 4 practice at this address. They are listed nearest first.
Clinicians, nearest first (4)
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 10D0919544
Indian River Medical Office PA · Titusville, FLFrequently 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 Indian River Medical Office PA's NPI number?
The NPI number for Indian River Medical Office PA is 1245220557. It was assigned to this organization in the NPPES registry on October 27, 2005.
Where is Indian River Medical Office PA located?
Indian River Medical Office PA is located at 3300 Dairy Rd, Titusville, FL 32796. The listed phone number is (321) 269-6530.
What is Indian River Medical Office PA's specialty?
The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.
Is Indian River Medical Office PA enrolled in Medicare?
Yes. Indian River Medical Office PA is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Indian River Medical Office PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians in 2 Medicare specialties reassign their Medicare billing to Indian River Medical Office PA. 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 Nurse Practitioner (3) and Internal Medicine (1). Of these, 4 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Indian River Medical Office PA hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 10D0919544) is associated with this NPI, valid through April 1, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Indian River Medical Office PA accept?
Health plans from Wellpoint list Indian River Medical Office PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Indian River Medical Office PA was last updated on March 3, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.
# Indian River Medical Office Pa · NPI 1245220557
Specialist organization in Titusville, Florida. Organization record, active in the CMS NPPES registry since October 27, 2005.
## Identity
- **NPI:** 1245220557 (Entity type: Organization)
- **Enumerated:** October 27, 2005
- **Primary specialty:** Specialist · taxonomy 174400000X
- **Organization subpart:** No
- **Authorized official:** Jill Whittamore, ADMINISTRATOR
## Practice location
- **Address:** 3300 DAIRY RD, Titusville, FL 32796-1512
- **Phone:** (321) 269-6530 · **Fax:** (321) 269-2334
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 4 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (3), Internal Medicine (1); 4 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 3, 2011
- **Other identifiers:** Other 40745 (FL); Medicare PIN 40745 (FL); Medicaid 250742100 (FL)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1245220557) · Data from the CMS NPPES public registry.