Mark Anthony Stawara, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME0044101 Issued in FL

Practice address

2035 Professional Ctr Dr
Suite C
Orange Park, FL 32073-4462

Phone

(904) 272-0384

Fax

(904) 272-6748

NPI assigned

May 10, 2006

Last updated

May 22, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

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  • NPI 1417987124
  Medicare reassignment

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400716800000",
    "number": "1033168539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2035 PROFESSIONAL CTR DR",
            "address_2": "SUITE C",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734462",
            "telephone_number": "904-272-0384",
            "fax_number": "904-272-6748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2035 PROFESSIONAL CTR DR",
            "address_2": "SUITE C",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734462",
            "telephone_number": "904-272-0384",
            "fax_number": "904-272-6748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAWARA",
        "first_name": "MARK",
        "middle_name": "ANTHONY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2014-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0044101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "068585200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Justin Myles Stark, D.O.
• Starkey Chiropractic Inc
• Beth Ann Starkey, DC
• Rodney Staten
• Vonda Elizabeth Staten, PSYD
• Kristin Danielle Steacy
• Andy Stephan Steczo, CRNA
• Sarah Elizabeth Steeg, OTR/L
• Ursula Stein, LCSW
• Kimberly C Stephens, MSN APRN FNP-BC

• Internal Medicine Physician in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.