Individual provider Active NPI

Marian Hanhan Preston, PA-C

  • Medical Physician Assistant
  • Tampa, FL
National Provider Identifier
1043690209
Registry record updated Jan 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9108807 Issued in FL
Practice address
3000 Medical Park Dr Ste 500
Tampa, FL 33613-6600
Phone
(813) 615-7028
Fax
(813) 615-8008
NPI assigned
Jun 3, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9108807 FL
Medical Physician Assistant 363AM0700X PA9108807 FL Primary

Addresses

Primary practice location

3000 Medical Park Dr Ste 500
Tampa, FL 33613-6600

Mailing address

3000 Medical Park Dr Ste 500
Tampa, FL 33613-6600
Phone (813) 615-7028

Other practice location 1

3000 Medical Park Dr Ste 340
Tampa, FL 33613-4681
Phone (813) 615-7028

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150916001103 FL Practitioner - Physician Assistant 2961719463 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Physician Group IncGroup PAC ID 2365679057, 953 clinicians

Practice addresses (Care Compare)

13901 Bruce B Downs Blvd
Tampa, FL 33613-3905
Phone (813) 615-7260

3100 E Fletcher Ave
Tampa, FL 33613-4613
Phone (813) 615-7075

Hospital & facility affiliations

National Provider Directory

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

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: mpreston73290@adventhealth.direct-ci.com

Organizations & group practices 1

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1433289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1043690209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 MEDICAL PARK DR STE 500",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336136600",
            "telephone_number": "813-615-7028",
            "fax_number": "813-615-8008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 MEDICAL PARK DR STE 500",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336136600",
            "telephone_number": "813-615-7028",
            "fax_number": "813-615-8008"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3000 Medical Park Dr Ste 340",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336134681",
            "country_code": "US",
            "telephone_number": "813-615-7028",
            "fax_number": "813-615-8008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRESTON",
        "first_name": "MARIAN",
        "middle_name": "HANHAN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-03",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9108807",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9108807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.