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SPACE COAST MEDICINE
NPI 1245931419
Internal Medicine in Melbourne Beach, FL

Active since March 15, 2023
310 AVENUE A, MELBOURNE BEACH, FL 32951(850) 544-0142 Get Directions Write a Review

NPPES record last updated: March 15, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Space Coast Medicine NPPES

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

SPACE COAST MEDICINE (NPI 1245931419) is a healthcare organization registered as an internal medicine in Melbourne Beach, Florida and active in the NPI registry since March 2023. The organization lists Anthony Herzog, Md, as its authorized official.

NPPES Registry Identity

NPI1245931419
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameSPACE COAST MEDICINE
Location Address310 AVENUE AMelbourne Beach, FL 32951-2201
Mailing AddressPo Box 510195Melbourne Beach, FL 32951-0195
Phone(850) 544-0142
Organization SubpartNo
Authorized OfficialAnthony HerzogMd · (850) 544-0142
Enumeration DateMarch 15, 2023
NPPES CertifiedMarch 15, 2023
✔ NPI 1245931419 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
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.
310 AVENUE A, Melbourne Beach, FL 32951
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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)

Space Coast Medicine is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Space Coast Medicine, which bills Medicare for the services this clinician delivers.

Clinician (1)

Anthony Herzog, MD
Internal Medicine
NPI 1003255019
1425 MALABAR RD NE
Palm Bay, FL 32907
(321) 434-8078
✔ PECOS✔ Accepts Medicare45 mi

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 Space Coast Medicine's NPI number?

The NPI number for Space Coast Medicine is 1245931419. It was assigned to this organization in the NPPES registry on March 15, 2023.

Where is Space Coast Medicine located?

Space Coast Medicine is located at 310 Avenue A, Melbourne Beach, FL 32951. The listed phone number is (850) 544-0142.

What is Space Coast Medicine's specialty?

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

Is Space Coast Medicine enrolled in Medicare?

Yes. Space Coast Medicine is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Space Coast Medicine?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Space Coast Medicine. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Space Coast Medicine was last updated on March 15, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.