Mark C. Donnelly, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS19518 Issued in FL

Practice address

2211 Lithia Center LN
Valrico, FL 33596-5676

Phone

(813) 660-7100

NPI assigned

May 4, 2015

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Tampa General Medical Group IncGroup PAC ID 7416253828, 353 clinicians

Sports and Orthopedic Rehabilitation Services IncGroup PAC ID 0840104253, shared by 4 NPIs, 314 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Vna Plus Home health agency, Tampa, FL, CCN 687180
• Tampa General Hospital Hospital, Tampa, FL, CCN 100128

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mdonnelly260872@direct.tgh.org
• FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Tampa General Medical Group Inc

  • Surgery Physician
  • Tampa, FL
  • NPI 1043557853
  Medicare reassignment Care Compare group NPD
• Tampa General Hospital

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1124558929
  NPD
• Tampa General Medical Group Inc

  • Cardiovascular Disease Physician
  • Sun City Center, FL
  • NPI 1144910316
  NPD
• Tampa General Medical Group Inc

  • Family Medicine Physician
  • Tampa, FL
  • NPI 1801133624
  NPD
• Tampa General Medical Group Inc

  • Family Medicine Physician
  • Tampa, FL
  • NPI 1164769063
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Florida Health Sciences Center Inc

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1235196510
  Care Compare affiliation
• Visiting Nurse Community Care of the West Coast, Inc.

  • Home Health Agency
  • Tampa, FL
  • NPI 1770586257
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1430697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678320000000",
    "number": "1013394576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1289",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336011289",
            "telephone_number": "813-660-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 LITHIA CENTER LN",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335965676",
            "telephone_number": "813-660-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONNELLY",
        "first_name": "MARK",
        "middle_name": "C.",
        "name_prefix": "Mr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-04",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "DO2397",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS19518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013394576",
            "state": "NV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdonnelly260872@direct.tgh.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2211 Lithia Center Ln",
            "city": "Valrico",
            "state": "FL",
            "country_code": "US",
            "postal_code": "335965676",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stacey A. Diorio, M.S., CCC-SP
• Divine Oasis Alf
• Divine Oasis Alf II, Inc
• Doctors in and Out Urgent Care
• Daniel Martin Dodard, MD
• Angela Irene Donner, ARNP
• Arina Sergeevna Doroshenko, DDS, MD
• Jordan Dorsey, NURSE PRACTITIONER
• Dr James M Petro OD, PA
• Dr. Chris Russell, PA

• Family Medicine Physician in Valrico, FL
• Providers in Valrico, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.