Individual provider Active NPI

Mark C. Gillespy, MD

  • Orthopaedic Surgery Physician
  • Daytona Beach, FL
National Provider Identifier
1073592606
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
ME52207 Issued in FL
Practice address
1865 Lpga Blvd
Daytona Beach, FL 32117-7108
Phone
(386) 255-4596
Fax
(386) 258-3561
NPI assigned
Jan 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X ME52207 FL
Orthopaedic Surgery Physician 207X00000X ME52207 FL Primary

Addresses

Primary practice location

1865 Lpga Blvd
Daytona Beach, FL 32117-7108

Mailing address

1865 Lpga Blvd
Daytona Beach, FL 32117-7108
Phone (386) 255-4596

Other practice location 1

1890 Lpga Blvd Ste 240
Daytona Beach, FL 32117-7131
Phone (386) 255-4596

Other practice location 2

1165 Dunlawton Ave Ste 102
Port Orange, FL 32127-2924
Phone (386) 255-4596

Other practice location 3

17 Old Kings Rd N Ste K
Palm Coast, FL 32137-8283
Phone (386) 255-4596

Other practice location 4

1075 Mason Ave
Daytona Beach, FL 32117-4611
Phone (386) 255-4596

Other practice location 5

1175 Dunlawton Ave Ste 1
Port Orange, FL 32127-4741
Phone (386) 255-4596

Other identifiers 2

IdentifierTypeStateIssuer
007651900MedicaidFL
370310000MedicaidFL

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
I20100311000352 FL Practitioner - Orthopedic Surgery 2062557333 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Jefferson Medical College of Thomas Jefferson University, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1865 Lpga Blvd
Daytona Beach, FL 32117-7108
Phone (386) 255-4596

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.71 of 100Reported as individual
Quality
80.56
Promoting interoperability
98
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement45
Knee replacement36
Spinal fusion1-10
Lower limb (leg) arthroscopy (minimally invasive joint repair)14
Laminectomy or laminotomy (partial removal of spine bones)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME52207FLMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Clinic of Daytona Beach PA Orthopaedic Surgery CurrentSince Feb 8, 1988 Accepting new patients
Orthopaedic Clinic of Daytona Beach PA Orthopaedic Surgery CurrentSince Feb 8, 1988 Accepting new patients

Locations

1075 Mason Ave
Daytona Beach, FL 32117
Phone (386) 255-4596

1865 Lpga Blvd
Daytona Beach, FL 32117
Phone (386) 255-4596

1890 Lpga Blvd
Ste 240
Daytona Beach, FL 32117
Phone (386) 255-4596

17 Old Kings Rd N
Ste K
Palm Coast, FL 32137
Phone (386) 255-4596

1165 Dunlawton Ave
Ste 102
Port Orange, FL 32127
Phone (386) 255-4596

1175 Dunlawton Ave
Ste 1
Port Orange, FL 32127
Phone (386) 255-4596

Interoperability endpoints

  • Direct secure messaging: mark.gillespy.1@10735.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/10735/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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 6

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": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1073592606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1865 LPGA BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321177108",
            "telephone_number": "386-255-4596",
            "fax_number": "386-258-3561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1865 LPGA BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321177108",
            "telephone_number": "386-255-4596",
            "fax_number": "386-258-3561"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1890 Lpga Blvd Ste 240",
            "address_purpose": "LOCATION",
            "city": "Daytona Beach",
            "state": "FL",
            "postal_code": "321177131",
            "country_code": "US",
            "telephone_number": "386-255-4596",
            "fax_number": "386-258-3561",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1165 Dunlawton Ave Ste 102",
            "address_purpose": "LOCATION",
            "city": "Port Orange",
            "state": "FL",
            "postal_code": "321272924",
            "country_code": "US",
            "telephone_number": "386-255-4596",
            "fax_number": "386-258-3561",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17 Old Kings Rd N Ste K",
            "address_purpose": "LOCATION",
            "city": "Palm Coast",
            "state": "FL",
            "postal_code": "321378283",
            "country_code": "US",
            "telephone_number": "386-255-4596",
            "fax_number": "386-258-3561",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1075 Mason Ave",
            "address_purpose": "LOCATION",
            "city": "Daytona Beach",
            "state": "FL",
            "postal_code": "321174611",
            "country_code": "US",
            "telephone_number": "386-255-4596",
            "fax_number": "386-258-3561",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1175 Dunlawton Ave Ste 1",
            "address_purpose": "LOCATION",
            "city": "Port Orange",
            "state": "FL",
            "postal_code": "321274741",
            "country_code": "US",
            "telephone_number": "386-255-4596",
            "fax_number": "386-258-3561",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILLESPY",
        "first_name": "MARK",
        "middle_name": "C.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-12",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "FL",
            "license": "ME52207",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "ME52207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007651900",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370310000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.