GINA BROCK (DO) – Family Medicine Physician, NPI 1154374668
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
6,722 FAMILY PRACTICE in FL
Provider Addresses for GINA BROCK (DO)
PO BOX 863639
ORLANDO, FL 328863639
Phone: (888) 680-6067
Fax: (800) 536-8431
Type: Mailing
400 Health Park Blvd
St Augustine, FL 320865784
Phone: (904) 826-4700
Fax: (800) 536-8431
Type: Location
1107 E 66th St
Savannah, GA 314045701
Phone: (912) 350-8837
Fax: (912) 350-5118
Type: Location
1107 E 66TH ST
SAVANNAH, GA 314045701
Phone: (912) 350-8837
Fax: (912) 350-5118
Type: Mailing
4700 WATERS AVE
SAVANNAH, GA 314046220
Phone: (912) 350-8715
Type: Location
Flagler Hospital, 400, Health Park Boulevard, St. Augustine, St. Johns County, Florida, 32086, United States
ST AUGUSTINE, FL 320865784
Phone: (904) 826-4700
Fax: (800) 536-8431
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-07-14
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20250714001577 | I | Family Practice | FL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 32886)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| R H E U M A T O L O G Y | KY | |
| Cardiovascular Disease (Cardiology), Internal Medicine | FL | |
| Physician Assistant | FL | |
| E N D O C R I N O L O G Y | MN | |
| - | FL | |
| Internal Medicine | FL | |
| - | IA | |
| Physician Assistant | FL | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | OH |
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