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BREVARD PRIMARY CARE LLC
NPI 1376958462
Internal Medicine - Infectious Disease in Melbourne, FL

Active since June 26, 2014
2328 CITADEL WAY STE 103-319, MELBOURNE, FL 32940(321) 757-1900(866) 376-2481 Get Directions Write a Review

NPPES record last updated: November 15, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Brevard Primary Care Llc NPPES

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

BREVARD PRIMARY CARE LLC (NPI 1376958462) is a healthcare organization registered as an infectious disease in Melbourne, Florida and active in the NPI registry since June 2014. The organization lists Bhavani M Puskur, Practice Owner, as its authorized official.

NPPES Registry Identity

NPI1376958462
Entity TypeOrganization
Primary Taxonomy207RI0200X
Legal Business NameBREVARD PRIMARY CARE LLC
Location Address2328 CITADEL WAY STE 103-319Melbourne, FL 32940-6459
Mailing Address2328 Citadel Way Ste 103-319Melbourne, FL 32940-6459
Phone(321) 757-1900
Fax(866) 376-2481
Organization SubpartNo
Authorized OfficialBhavani M PuskurPractice Owner · (321) 948-8555
Enumeration DateJune 26, 2014
Last NPPES UpdateNovember 15, 2024
NPPES CertifiedNovember 15, 2024
✔ NPI 1376958462 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Infectious DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RI0200X
Definition
An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine.
Also ListedInternal MedicineTaxonomy 207R00000X
2328 CITADEL WAY STE 103-319, Melbourne, FL 32940
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Group Practice 2

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP
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)

Brevard Primary Care Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

6

Medicare enrollment records show 6 clinicians reassign Medicare billing to Brevard Primary Care LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 4 within 10 miles. They are listed nearest first.

Clinicians, nearest first (6)

Bhavani Puskur, MD
Infectious Disease
NPI 1760453427
2328 CITADEL WAY STE 103-319
Melbourne, FL 32940
(321) 757-1900
✔ PECOS✔ Accepts MedicareSame address
Kimberly Havens, APRN
Nurse Practitioner
NPI 1336713965
2555 JUDGE FRAN JAMIESON WAY
Viera, FL 32940
(321) 615-5800
✔ PECOS✔ Accepts Medicare0.2 mi
Pushpa Daliya, APRN
Nurse Practitioner
NPI 1841761673
7332 OFFICE PARK PL STE 103
Melbourne, FL 32940
(321) 327-9788
✔ PECOS✔ Accepts Medicare1.4 mi
Christina Mattes, APRN
Nurse Practitioner
NPI 1316719685
1301 W EAU GALLIE BLVD STE 108
Melbourne, FL 32935
(321) 622-8730
✔ PECOS✔ Accepts Medicare9.7 mi
Amy Jagdmann
Nurse Practitioner
NPI 1184268856
109 SILVER PALM AVE
Melbourne, FL 32901
(321) 837-9015
✔ PECOS✔ Accepts Medicare13 mi
Eliza Charles
Nurse Practitioner
NPI 1245098425
261 WADING BIRD CIR SW
Palm Bay, FL 32908
(321) 223-8657
✔ PECOS17 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 Brevard Primary Care LLC's NPI number?

The NPI number for Brevard Primary Care LLC is 1376958462. It was assigned to this organization in the NPPES registry on June 26, 2014.

Where is Brevard Primary Care LLC located?

Brevard Primary Care LLC is located at 2328 Citadel Way Ste 103-319, Melbourne, FL 32940. The listed phone number is (321) 757-1900.

What is Brevard Primary Care LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Infectious Disease, with taxonomy code 207RI0200X.

Is Brevard Primary Care LLC enrolled in Medicare?

Yes. Brevard Primary Care LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Brevard Primary Care LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians in 2 Medicare specialties reassign their Medicare billing to Brevard Primary Care 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 Nurse Practitioner (5) and Infectious Disease (1). Of these, 1 practice at this address and 4 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 Brevard Primary Care LLC was last updated on November 15, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 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.