Space Coast Endoscopy Center – Ambulatory Surgical Clinic/Center, NPI 1124092945
Ambulatory Surgical Clinic/Center
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Space Coast Endoscopy Center
PO BOX 561350
ROCKLEDGE, FL 329561350
Phone: (321) 504-4440
Fax: (321) 504-4470
Type: Mailing
1A BURTON HILLS BLVD STE 300
NASHVILLE, TN 372156153
Phone: (615) 240-3820
Fax: (615) 234-1720
Type: Mailing
1974 ROCKLEDGE BLVD STE 102
ROCKLEDGE, FL 329553756
Phone: (321) 504-4440
Fax: (321) 504-4470
Type: Location
Rockledge Boulevard, Rockledge, Brevard County, Florida, 32956, United States
SUITE 102
ROCKLEDGE, FL 329553723
Phone: (321) 504-4440
Fax: (615) 234-1720
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: 2005-05-20
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 |
|---|---|---|---|---|
| O20050520000057 | O | Ambulatory Surgical Center | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 45385 | Removal of polyps or growths of large bowel using an endoscope with mechanical snare | 806 | 802 | $0 |
| 43239 | Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope | 681 | 649 | $0 |
| 45380 | Biopsy of large bowel using a flexible endoscope | 425 | 422 | $0 |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 200 | 199 | $0 |
| 43249 | Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, less than 3.0 cm | 114 | 99 | $0 |
Insurance plans in this area (ZIP 32956)
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