2019 Provider/Pharmacy Directory - Health First

2019 Provider/Pharmacy Directory

Classic Plan (HMO-POS) Rewards Plan (HMO)

Value Plan (HMO) Secure Plan (HMO)

Employer Group Plans (HMO-POS and HMO)

This directory provides a list of Health First Health Plans' current network providers.

This directory is for members living in Brevard and Indian River Counties in Florida.

All network providers in this directory are available to you for covered services. These providers practice in the following counties: Brevard, Flagler, Hardee, Highlands, Indian River, Orange, Osceola, Seminole and Volusia Counties.

For information about additional providers who participate in our network, please contact us or visit our website.

This directory is current as of December 3, 2019.

Some network providers may have been added or removed from our network after this directory was printed. We do not guarantee that each provider is still accepting new members. To access Health First Health Plans' online provider directory, and to get the most up-to-date information about Health First Health Plans' network providers in your area, you can visit .

Changes to our pharmacy network may occur during the benefit year. An updated directory is located on our website at . You may also call Customer Service for an updated directory.

For any questions about the information contained in this directory (hardcopy or online), please call our Customer Service Department at 1.800.716.7737 weekdays from 8 a.m. to 8 p.m. and Saturdays from 8 a.m. to noon. From October 1 to March 31, we're available seven days a week from 8 a.m. to 8 p.m. TTY/TDD users should call 1.800.955.8771.

Health First Health Plans is an HMO plan with a Medicare contract. Enrollment in Health First Health Plans depends on contract

renewal.

For information about alternative provider directory formats, please contact our Customer Service Department.

Y0089_EL6503_NM

HF-SLS-PDIR-K16-E-19

Table of Contents

Section 1 ? Introduction Bills from out-of-network providers ................................................................................................... 2

Coverage when traveling or in an emergency ..................................................................................... 2

What is the service area for Health First Health Plans? ...................................................................... 3

How do you find Health First Health Plans' providers in your area? ................................................. 3

Section 2 ? List of Network Providers.......................................................................................................... 4

Primary Care Physicians ...................................................................................................................... 5

Specialists .......................................................................................................................................... 92

Outpatient Mental Health Providers ................................................................................................ 334

Hospitals & Emergency Departments.............................................................................................. 363

Skilled Nursing Facilities (SNF)...................................................................................................... 379

Pharmacies ....................................................................................................................................... 385

2

Section 1 ? Introduction

This directory provides a list of Health First Health Plans' network providers. To get detailed information about your health care coverage, please see your Evidence of Coverage.

Regardless of which type of plan you have, Health First Health Plans does not require you to select a Primary Care Physician (PCP), but it's still important to establish a relationship with a doctor for your preventive and primary care and to coordinate any specialty care you may need. The term "PCP" will be used throughout this directory.

Many services today are offered by physician assistants, nurse practitioners or others who are not licensed as physicians. These services are rendered in accordance with Florida regulations, and require the same cost share as you would pay for seeing a physician.

The "network providers" listed in this directory have agreed to provide you with your health care services. You may go to any of our network providers listed in this directory. If you have been going to one network provider, you are not required to continue to go to that same provider. In some cases, you may get covered services from nonnetwork providers. This directory includes providers with offices in the area near where you live. For a list of other providers in our network, please contact us or visit our web site.

If your plan includes point-of-service (POS) benefits, you may see providers out of the network. If a bill is sent directly to you after seeing an out-ofnetwork provider, submit the bill to Health First Health Plans for processing and determination of enrollee liability, if any.

Health First Health Plans does not require members or their providers to obtain a referral for covering medically necessary services, but some specialists may require referrals from primary care physicians. Also, some services may require prior authorization.

If you receive bills from out-of-network

providers that you believe should be

paid by Health First Health Plans

Health First Health Plans covers certain health care services that may be obtained from out-of-network providers. These include:

Care for a medical emergency Urgently needed care Kidney dialysis services that you get at a

Medicare-certified dialysis facility when you are temporarily outside the plan's service area. (If possible, please call Customer Service before you leave the service area so we can help arrange for you to have maintenance dialysis while you are away.) Care that has been approved in advance by Health First Health Plans Any services which were ordered to be covered through an appeals process

Sometimes an out-of-network provider may ask or require you to pay for any of these covered services. The out-of-network provider has a right to get his/her fees, but does not have a right to get them from you. You should ask them to bill us first. In cases where you have already paid for the covered services, we will reimburse you for our share of the cost. You should never pay any out-of-network provider more than what is allowed by Medicare. If you get a bill asking for payment, you can send the bill to us for payment. We will pay your out-ofnetwork provider for our share of the bill and will let you know what, if anything, you must pay.

For questions regarding any of these situations, contact Customer Service toll-free at 1.800.716.7737 (TTY/TDD relay: 1.800.955.8771) weekdays from 8 a.m. to 8 p.m. and Saturdays from 8 a.m. to noon. From October 1 to March 31, we're available seven days a week from 8 a.m. to 8 p.m.

You will also find detailed information in your Evidence of Coverage.

Coverage when traveling out of the

plan's service area or in an emergency

If you need care when you are outside the service area, your health care coverage is limited. Unless your plan includes POS benefits, the only services we cover when you are outside our service area are:

Care for a medical emergency, including maintenance care and hospital care after you are stable (known as post-stabilization care)

Urgently needed care Renal dialysis (kidney)

 Care that has been approved in advance by Health First Health Plans

For more information about medical emergency and urgently needed care, review the Evidence of Coverage. If you question whether a service is covered when you travel, call Customer Service toll-free at 1.800.716.7737 (TTY/TDD relay: 1.800.955.8771) weekdays from 8 a.m. to 8 p.m. and Saturdays from 8 a.m. to noon. From October 1 to March 31, we're available seven days a week from 8 a.m. to 8 p.m.

Unless your plan includes POS benefits, you must use network providers except in emergency or urgent care situations or for out-of-area renal dialysis or other services. If you obtain routine care from out-of-network providers, neither Medicare nor Health First Health Plans will be responsible for the costs.

When out of the service area, you can obtain renal dialysis services from any Medicare-certified dialysis facility. (If possible, please call Customer Service before you leave the service area so we can help arrange for you to have maintenance dialysis while you are away.)

If your plan includes POS benefits, with the exception of emergencies or urgent care, it may cost more to get care from out-of-network providers.

What is the service area for Health First

Health Plans?

Members who live in the following counties may utilize the Providers listed in this directory, regardless of what county the Provider operates within: Brevard County Indian River County

All network providers in this directory are available to you for covered services. These providers practice in the following counties:

Brevard County Flagler County Hardee County Highlands County Indian River County Orange County Osceola County Seminole County

3

Volusia County

How do you find Health First Health Plans providers in your area?

The directory is organized by physician type (PCPs, specialists, etc.), then by county and then by provider specialty. The address of each provider is included to help you find providers with locations most convenient for you.

If you have questions about Health First Health Plans, call our Customer Service Department tollfree at 1.800.716.7737 (TTY/TDD relay: 1.800.955.8771) weekdays from 8 a.m. to 8 p.m. and Saturdays from 8 a.m. to noon. From October 1 to March 31, we're available seven days a week from 8 a.m. to 8 p.m. You can also visit .

Behavioral and mental health

We contract with Magellan Behavioral Health (Magellan) to manage mental health and substance abuse services for our members. Magellan is a leader in behavioral health care management with services that help individuals and families to recover, improve their overall health, and achieve wellness. Magellan connects members with the right care when it is needed most. Magellan manages care for both inpatient and outpatient services and also provides crisis intervention at any time day or night.

Local providers are listed in this directory. You can find a complete nationwide listing of providers at . You can also find online tools, resources and general educational information addressing health and well-being issues.

For more information or to access behavioral health services, including services outside of Brevard and Indian River Counties, call Magellan directly at 1.800.424.4347 (TDD/TTY: 1.800.424.1694).

You don't need a referral to access your behavioral health benefits. However, we recommend you call the help line for assistance in selecting a provider and understanding your benefits.

Magellan Behavioral Health, Inc. is a subsidiary of

Magellan Health Services, Inc.

4

Section 2 ? List of Network Providers

This Provider Directory consists of 1,144 Primary Care Physicians, 2,730 Specialists, 715 Outpatient Mental Health Providers, 23 Hospitals, 42 Skilled Nursing Facilities, 51 Urgent Care Centers, and 268 Pharmacies.

BREVARD

Medicare Advantage

Primary Care Physicians

5 December 3, 2019

BREVARD COUNTY

Concierge Medicine - Primary Care Providers

Pinsky, Mark F., DO*

Gender: Male

Medical Associates of Brevard, LLC A Concierge Primary Care Physician is a physician to which the member pays an annual fee or retainer to be part of the physician's panel. This fee is paid directly to the physician. The member is still required to pay any cost share required.

8045 Spyglass Hill Rd, Ste 101, Melbourne 32940 .. (321) 255-2289

Arnold, Arthur A., MD

Gender: Male Hospital Privileges:

Arnold Primary Care A Concierge Primary Care Physician is a physician to which the member pays an annual fee or retainer to be part of the physician's panel. This fee is paid directly to the physician. The member is still required to pay any cost share required.

Holmes Regional Medical Center Age Requirement: 5 years and older

Family Medicine

1395 N. Courtenay Pkwy, Ste 207, Merritt Island 32953 ..(321) 3055978

Adamson, Dale B., MD

Gender: Male

Certification(s): American Board of Preventive Medicine Additional language(s) spoken: Spanish Age Requirement: 12 years and older

Berk, Danny P., MD

Gender: Male

Medical Associates of Brevard, LLC

A Concierge Primary Care Physician is a physician to which the

member pays an annual fee or retainer to be part of the physician's

panel. This fee is paid directly to the physician. The member is still

required to pay any cost share required.

Health First Medical Group 220 N. Sykes Creek Pkwy, Ste 301, Merritt Island 32953 (321) 8687222

Certification(s): American Board of Family Medicine Age Requirement: 18 years and older

Anderson, Thomas N., DO

Gender: Male

Medical Associates of Brevard, LLC 3040 N. Wickham Rd, Ste 10, Melbourne 32935...... (321) 428-4840

Certification(s): American Osteopathic Board of Family

Practice

8057 Spyglass Hill Rd, Ste 104, Melbourne 32940...(321) 241-4877 Age Requirement: 6 years and older

Age Requirement: 3 years and older

Arcand, Josee J., MD*

Gender: Female

Ireland, Mark L., DO

Gender: Male Arcand Family Practice, LLC

Medical Associates of Brevard, LLC

8055 Spyglass Hill Rd, Ste 103, Melbourne 32940 .. (321) 255-7334

A Concierge Primary Care Physician is a physician to which the Certification(s): American Board of Family Medicine

member pays an annual fee or retainer to be part of the physician's Additional language(s) spoken: French

panel. This fee is paid directly to the physician. The member is still Age Requirement: 5 years and older

required to pay any cost share required. 1380 S. Patrick Dr, Satellite Beach 32937 ................(321) 773-2659

Arias, Erich A., MD

Gender: Male

Certification(s): American Board of Family Medicine Age Requirement: All Ages

Healthy Living Clinic, LLC 1300 Florida Ave, Rockledge 32955......................... (321) 549-2273

Certification(s): American Board of Family Medicine

Nunes, Christopher S., MD

Gender: Male Hospital Privileges:

Medical Associates of Brevard, LLC A Concierge Primary Care Physician is a physician to which the member pays an annual fee or retainer to be part of the physician's panel. This fee is paid directly to the physician. The member is still required to pay any cost share required.

Cape Canaveral Hospital Viera Hospital Additional language(s) spoken: Spanish Age Requirement: 2 years and older

8057 Spyglass Hill Rd, Ste 104, Melbourne 32940...(321) 241-4877 Badolato, David W., MD*

Gender: Male

Certification(s): American Board of Internal Medicine Premier Primary Care

Hospital Privileges:

6300 N. Wickham Rd, Ste 101, Melbourne 32940.... (321) 253-2169

Holmes Regional Medical Center

Certification(s): American Board of Family Medicine

Age Requirement: 4 years and older

Hospital Privileges:

Viera Hospital

Age Requirement: 1 year and older

* Accepting established patients only

BREVARD

6 Primary Care Physicians December 3, 2019

Medicare Advantage

Badolato, Stephen K., MD*

Gender: Male Britton-King, Mary B., APRN

Gender: Female

Premier Primary Care

Two Rivers Family Practice, PLLC

6300 N. Wickham Rd, Ste 101, Melbourne 32940 ... (321) 253-2169 1231 S. Patrick Dr, Satellite Beach 32937 ................(321) 622-5432

Certification(s): American Board of Family Medicine,

Age Requirement: 6 years and older

American Board of Family Medicine (Sub: Sports

Medicine)

Age Requirement: 1 year and older

Brogan, Terri-Ann K., DO

Gender: Female

North Point Physicians, LLC 1395 N. Courtenay Pkwy, Ste 107, Merritt Island 32953 ..(321) 453-

Beatty, Rachel L., APRN

Gender: Female 1955

Complete Care, LLC

Certification(s): American Osteopathic Board of Family

590 Malabar Rd, SE, Ste 7, Palm Bay 32907........... (321) 985-9097 Practice

2400 N. Courtenay Pkwy, Ste 100, Merritt Island 32953.. (321) 985- Hospital Privileges:

9097

Cape Canaveral Hospital

Age Requirement: 5 years and older

Age Requirement: 5 years and older

Bhatt, Ami A., MD

Gender: Female Buddha, Chaithanya Deepthi, MD Gender: Female

Suntree Internal Medicine

Vinay Kumar, MD, PA

6619 N. Wickham Rd, Melbourne 32940.................. (321) 259-9500

2070 US Hwy 1, Ste 103, Rockledge 32955 .............(321) 632-0552

Certification(s): American Board of Family Medicine Certification(s): American Board of Family Medicine

Hospital Privileges:

Additional language(s) spoken: Hindi

Viera Hospital

Age Requirement: 16 years and older

Age Requirement: 18 years and older

Capraro, Frances, MD

Gender: Female

Bisset, Robert K., MD*

Gender: Male Two Rivers Family Practice, PLLC

Health First Medical Group

1231 S. Patrick Dr, Satellite Beach 32937 ................(321) 622-5432

1220 Hwy A1A, Ste 147, Indialantic 32903 .............. (321) 549-0830

Certification(s): American Board of Family Medicine

Certification(s): American Board of Family Medicine Age Requirement: 6 years and older

Hospital Privileges: Holmes Regional Medical Center Age Requirement: 18 years and older

Celestin Louis, Ketsia, MD

Gender: Female

Health First Medical Group

105 S. Banana River Blvd, 2nd Fl, Cocoa Beach 32931...(321) 868-

Black, Janis G., DO

Gender: Female 8312

Family Health Center at Port St John

Certification(s): American Board of Family Medicine

3740 Curtis Blvd, Ste 108, Port Saint John 32927 ... (321) 633-5500 Additional language(s) spoken: French

Age Requirement: All Ages

Age Requirement: 10 years and older

Bonnell, Tiffany A., APRN

Gender: Female Chan, Edwin C., MD*

Gender: Male

Health First Medical Group

Suntree Internal Medicine

220 N. Sykes Creek Pkwy, Ste 301, Merritt Island 32953 (321) 361- 6619 N. Wickham Rd, Melbourne 32940 ..................(321) 259-9500

5534

Certification(s): American Board of Family Medicine

Age Requirement: All Ages

Hospital Privileges:

Brandes, Wayne, DO

Gender: Male

Health First Medical Group

389 Commerce Pkwy, Ste 120, Rockledge 32955 ... (321) 434-6555

Certification(s): American Osteopathic Board of Family

Cape Canaveral Hospital Viera Hospital Additional language(s) spoken: Chinese Age Requirement: 18 years and older

Practice

Clark, Desra K., DO

Gender: Female

Hospital Privileges:

Brevard Health Alliance

Viera Hospital

7227 N. US Hwy 1, Cocoa 32927 .............................(321) 877-2740

Age Requirement: 5 years and older

Certification(s): American Osteopathic Board of Family

Brits, Anri, MD Health First Medical Group

Gender: Female

Practice Age Requirement: All Ages

7125 Murrell Rd, Ste D, Melbourne 32940 ............... (321) 434-2524

Cohen, Leon A., MD

Gender: Male

Certification(s): American Board of Family Medicine Leon A. Cohen, MD, PA

Additional language(s) spoken: Afrikaans

375 S. Courtenay Pkwy, Ste 1, Merritt Island 32952.(321) 453-3420

Age Requirement: All Ages

Age Requirement: All Ages

* Accepting established patients only

BREVARD

Medicare Advantage

Primary Care Physicians 7 December 3, 2019

Condo, Allen R., MD

Gender: Male Fair, Susan C., DO*

Gender: Female

Health First Medical Group

Susan C. Fair, DO, PA

730 Malabar Rd, Ste B, Malabar 32950 ....................(321) 312-3470

595 N. Courtenay Pkwy, Ste 102, Merritt Island 32953 .... (321) 455-

Certification(s): American Board of Family Medicine 1226

Age Requirement: All Ages

Certification(s): American Osteopathic Board of

Cooper, Kinard, APRN

Gender: Male

Brevard Health Alliance 1361 Florida Ave, NE, Ste 2, Palm Bay 32905 .........(321) 241-6800

Age Requirement: All Ages

General Practice Hospital Privileges: Cape Canaveral Hospital Age Requirement: 5 years and older

Craig, Katherine, APRN*

Gender: Female

Health First Medical Group

1223 Gateway Dr, Melbourne 32901 ........................(321) 312-3457

Age Requirement: All Ages

Ferguson, Julie, APRN*

Gender: Female

Health First Medical Group

7125 Murrell Rd, Ste D, Melbourne 32940 ............... (321) 434-9562

Age Requirement: All Ages

Crane, Lydia O., MD*

Gender: Female

Health First Medical Group

1220 Hwy A1A, Ste 147, Indialantic 32903 ...............(321) 549-0885

Certification(s): American Board of Family Medicine

Flaherty, John W., MD

Gender: Male

Health First Medical Group 1855 Knox McRae Dr, Titusville 32780..................... (321) 269-2028

Age Requirement: 16 years and older

Hospital Privileges:

Fotopoulos, Evangelia I., MD

Gender: Female

Holmes Regional Medical Center Age Requirement: 5 years and older

Steward Medical Group, Inc 240 N. Wickham Rd, Ste 204, Melbourne 32935...... (321) 775-1300

Cushmore-Womble, Marie, MD Brevard Health Alliance

Gender: Female

Certification(s): American Board of Family Medicine Age Requirement: 16 years and older

2120 Sarno Rd, Melbourne 32935 ............................(321) 241-6800

Frank, Melissa M., APRN

Gender: Female

Age Requirement: All Ages

Medical Associates of Brevard, LLC

Daniels, Cori M., APRN Shane C. Hernesman, MD, PA

Gender: Female

8057 Spyglass Hill Rd, Ste 104, Melbourne 32940 .. (321) 241-4877

Age Requirement: 18 years and older

1980 N. Atlantic Ave, Ste 602, Cocoa Beach 32931.(321) 453-5888 Garcia, Jose L., MD*

Gender: Male

Age Requirement: 10 years and older

Health First Medical Group

Das, Rajive K., MD

3425 Bayside Lakes Blvd, SE, Ste 110, Palm Bay 32909 (321) 434-

Gender: Male 3430

Medical Associates of Brevard, LLC 1071 Port Malabar Blvd, Ste 111, Palm Bay 32905 ..(321) 725-9800

Certification(s): American Board of Family Medicine Hospital Privileges:

Certification(s): American Board of Family Medicine Palm Bay Hospital

Hospital Privileges: Holmes Regional Medical Center

Additional language(s) spoken: Spanish Age Requirement: 2 years and older

Additional language(s) spoken: Hindi

Age Requirement: 6 years and older

Garvin, Thomas L., MD

Gender: Male

Davis, Randal, DO

Brevard Health Alliance

Gender: Male 17 Silver Palm Ave, Melbourne 32901...................... (321) 733-2021

Health First Medical Group 7227 N. US Hwy 1, Ste 100, Port Saint John 32927.(321) 637-1595 1855 Knox McRae Dr, Titusville 32780 .....................(321) 269-2028

1361 Florida Ave, NE, Ste 2, Palm Bay 32905 ......... (321) 241-6800

Certification(s): American Board of Family Medicine Age Requirement: All Ages

Certification(s): American Osteopathic Board of Family

Practice

Gayed, Esmat A., MD

Gender: Male

Age Requirement: 7 years and older

Medical Associates of Brevard, LLC

Fadigan, Skyhawk, MD*

3021 W. Eau Gallie Blvd, Ste 101, Melbourne 32934(321) 255-0959

Gender: Female Hospital Privileges:

Health First Medical Group 220 N. Sykes Creek Pkwy, Ste 301, Merritt Island 32953.(321) 3615534

Certification(s): American Board of Family Medicine

Holmes Regional Medical Center Additional language(s) spoken: Arabic Age Requirement: 13 years and older

Hospital Privileges:

Cape Canaveral Hospital

Age Requirement: 5 years and older

* Accepting established patients only

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