Individual provider Active NPI

Mark Salvatore Ritchie, PA-C

  • Physician Assistant
  • Palatka, FL
National Provider Identifier
1043306582
Registry record updated Dec 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9107818 Issued in FL
Practice address
611 Zeagler Dr
Palatka, FL 32177-3810
Phone
(386) 328-5711
NPI assigned
Oct 4, 2006
Last updated
Dec 16, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9107818 FL Primary

Addresses

Primary practice location

611 Zeagler Dr
Palatka, FL 32177-3810

Mailing address

611 Zeagler Dr
Palatka, FL 32177-3810
Phone (386) 328-5711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, FL, GA, VA, AL, SC6 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 6

Enrollment IDStateProvider typePAC IDDetails
I20130731000863 NC Practitioner - Physician Assistant 6608972559 Reassigns benefits to 3 organizations
I20160517001855 FL Practitioner - Physician Assistant 6608972559 Reassigns benefits to 10 organizations
I20191105003282 GA Practitioner - Physician Assistant 6608972559 Reassigns benefits to 5 organizations
I20210128001937 VA Practitioner - Physician Assistant 6608972559 Reassigns benefits to 3 organizations
I20210701003798 AL Practitioner - Physician Assistant 6608972559 Reassigns benefits to 3 organizations
I20240910001698 SC Practitioner - Physician Assistant 6608972559 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
011543NYMDMental Health Counselor
3715SCMDOccupational Therapy Assistant
PA9107818FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Epn Urgent Care LLC Current Accepting new patients
Adventist Health System/ Sunbelt, Inc. Physician Assistant CurrentSince Jan 4, 2019 Accepting new patients
Adventist Health System/ Sunbelt, Inc. Physician Assistant CurrentSince Jan 4, 2019 Accepting new patients
University of Florida Jacksonville Physicians Inc CurrentSince Aug 31, 2022 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Aug 31, 2022 Accepting new patients
Atlantic Physician Services of Maryland, PC Physician Assistant Past Accepting new patients

Locations

440 W State Road 436
Altamonte Springs, FL 32714
Phone (407) 788-2000

3625 University Blvd S
Jacksonville, FL 32216
Phone (904) 333-9404

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

6400 Davis Blvd
Ste 103
Naples, FL 34104
Phone (239) 304-0054

120 Health Park Blvd
St Augustine, FL 32086
Phone (888) 481-2135

Organizations & group practices 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671148800000",
    "number": "1043306582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 ZEAGLER DR",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321773810",
            "telephone_number": "386-328-5711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 ZEAGLER DR",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321773810",
            "telephone_number": "386-328-5711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RITCHIE",
        "first_name": "MARK",
        "middle_name": "SALVATORE",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2022-12-16",
        "certification_date": "2022-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9107818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palatka, FL

Sources for this page

Verify at the official NPI Registry.