INTENSIVE CARE CONSORTIUM INC – Specialist, NPI 1629019062
Specialist
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for INTENSIVE CARE CONSORTIUM INC
1700 S 23rd St
Fort Pierce, FL 349504803
Phone: (561) 997-0821
Fax: (561) 997-0849
Type: Location
3651 Wheeler Rd
Augusta, GA 309096521
Phone: (615) 372-5068
Fax: (844) 867-4017
Type: Location
333 Borthwick Ave
Portsmouth, NH 038014198
Phone: (603) 433-4034
Fax: (603) 433-5169
Type: Location
2000 HEALTH PARK DR
BRENTWOOD, TN 370274692
Phone: (615) 373-7406
Type: Mailing
PO BOX 266211
WESTON, FL 333266211
Phone: (561) 967-4118
Fax: (561) 967-3463
Type: Mailing
Aventura Hospital and Medical Center, 20900, Biscayne Boulevard, Aventura, Miami-Dade County, Florida, 33180, United States
AVENTURA, FL 33180
Phone: (561) 997-0821
Fax: (561) 997-0849
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: 2026-01-29
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2023-09-30 (980 days ago).
Enrollment records
10
Earliest due date
2023-09-30
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 |
|---|---|---|---|---|
| O20050808000883 | O | Clinic/Group Practice | FL | 2023-09-30 |
| O20101206000106 | O | Clinic/Group Practice | GA | 2023-09-30 |
| O20131024001493 | O | Clinic/Group Practice | VA | TBD |
| O20150915000034 | O | Clinic/Group Practice | NH | 2023-09-30 |
| O20151005002117 | O | Clinic/Group Practice | TN | 2023-10-31 |
| O20160210001913 | O | Clinic/Group Practice | UT | TBD |
| O20180924002251 | O | Clinic/Group Practice | SC | 2023-09-30 |
| O20191021000114 | O | Clinic/Group Practice | DC | 2024-10-31 |
| O20220324002887 | O | Clinic/Group Practice | ID | TBD |
| O20260129000147 | O | Clinic/Group Practice | KY | TBD |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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 34950)
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