SPACE COAST PODIATRY LLC
NPI 1740037597
Podiatrist - Foot & Ankle Surgery in Palm Bay, FL
About Space Coast Podiatry Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SPACE COAST PODIATRY LLC (NPI 1740037597) is a healthcare organization registered as a foot & ankle surgery in Palm Bay, Florida and active in the NPI registry since April 2024. The organization lists Mark Allen Vaughn, Ceo/physician, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
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 Podiatry Llc 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 Podiatry LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
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 Podiatry LLC's NPI number?
The NPI number for Space Coast Podiatry LLC is 1740037597. It was assigned to this organization in the NPPES registry on April 30, 2024.
Where is Space Coast Podiatry LLC located?
Space Coast Podiatry LLC is located at 6100 Minton Rd NW Ste 101, Palm Bay, FL 32907. The listed phone number is (321) 802-4075.
What is Space Coast Podiatry LLC's specialty?
The primary specialty registered for this NPI is Podiatrist, specializing in Foot & Ankle Surgery, with taxonomy code 213ES0103X.
Is Space Coast Podiatry LLC enrolled in Medicare?
Yes. Space Coast Podiatry LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Space Coast Podiatry LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Podiatry) reassigns their Medicare billing to Space Coast Podiatry 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. 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 Podiatry LLC was last updated on September 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Space Coast Podiatry Llc · NPI 1740037597
Foot & Ankle Surgery organization in Palm Bay, Florida. Organization record, active in the CMS NPPES registry since April 30, 2024.
## Identity
- **NPI:** 1740037597 (Entity type: Organization)
- **Enumerated:** April 30, 2024
- **Primary specialty:** Podiatrist - Foot & Ankle Surgery · taxonomy 213ES0103X
- **Organization subpart:** No
- **Authorized official:** Mark Vaughn, CEO/PHYSICIAN
## Practice location
- **Address:** 6100 MINTON RD NW STE 101, Palm Bay, FL 32907-1900
- **Phone:** (321) 802-4075
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Podiatry) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 9, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1740037597) · Data from the CMS NPPES public registry.