Individual provider Active NPI

Robert A. Marino, M.D.

  • Urology Physician
  • Orange Park, FL
National Provider Identifier
1053468967
Registry record updated Jan 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
ME0057884 Issued in FL
Practice address
2045 Professional Center Dr
Orange Park, FL 32073-4461
Phone
(904) 276-1580
Fax
(904) 276-9586
NPI assigned
Jan 4, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X ME0057884 FL Primary

Addresses

Primary practice location

2045 Professional Center Dr
Orange Park, FL 32073-4461

Mailing address

2045 Professional Center Dr
Orange Park, FL 32073-4461
Phone (904) 276-1580

Other identifiers 4

IdentifierTypeStateIssuer
4200778OtherFLAETNA
051938300MedicaidFL
000958746AMedicaidGA
1RXJ6OtherFLBLUE CROSS BLUE SHIELD

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070905000442 FL Practitioner - Urology 4082707146 Reassigns benefits to 1 organization
Practice locations: Orange Park, FL

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Oklahoma College of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

15255 Max Leggett Pkwy
Jacksonville, FL 32218-7213
Phone (904) 383-1000

653 W 8TH St
Jacksonville, FL 32209-6511
Phone (904) 244-1680

655 W 8TH St
Jacksonville, FL 32209-6511
Phone (940) 244-4218

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
59.59 of 100Reported as apm
Quality
59.93
Promoting interoperability
0
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME0057884FLMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians, Inc. Current Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Apr 1, 2007 Accepting new patients
University of Florida Jacksonville Physicians Inc CurrentSince Apr 1, 2007 Accepting new patients
North Florida Acute Care Specialists LLC PastSince Feb 1, 2009 Accepting new patients
North Florida Gastroenterology LLC Past Accepting new patients

Locations

15255 Max Leggett Pkwy
Ste 3100
Jacksonville, FL 32218
Phone (904) 383-1015

15255 Max Leggett Pkwy
Ste 4900
Jacksonville, FL 32218
Phone (904) 244-3406

653 W 8th St
Fl 2
Jacksonville, FL 32209
Phone (904) 244-7281

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

Interoperability endpoints

  • Direct secure messaging: rmarino54609@direct.shands.ufl.edu

Organizations & group practices 5

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": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515110400000",
    "number": "1053468967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2045 PROFESSIONAL CENTER DR",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734461",
            "telephone_number": "904-276-1580",
            "fax_number": "904-276-9586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 PROFESSIONAL CENTER DR",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734461",
            "telephone_number": "904-276-1580",
            "fax_number": "904-276-9586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINO",
        "first_name": "ROBERT",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2018-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME0057884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4200778",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051938300",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000958746A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1RXJ6",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

Verify at the official NPI Registry.