Individual provider Active NPI

Jacob Ariel Marder, DNP

  • Family Nurse Practitioner
  • West Palm Beach, FL
National Provider Identifier
1154934149
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11008886 Issued in FL
Practice address
1411 N Flagler Dr Ste 9000
West Palm Beach, FL 33401-3421
Phone
(561) 584-8460
Fax
(561) 935-5537
NPI assigned
Aug 28, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X APRN11008886 FL
Family Nurse Practitioner 363LF0000X APRN11008886 FL Primary

Addresses

Primary practice location

1411 N Flagler Dr Ste 9000
West Palm Beach, FL 33401-3421

Mailing address

1411 N Flagler Dr Ste 9000
West Palm Beach, FL 33401-3421

Other names 1

  • Dr. Jacob Marder Former name

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
I20201001002138 FL Practitioner - Nurse Practitioner 7214356757 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Group practices
Jacob a Marder DNP PA Flagler DermatologyGroup PAC ID 8820452394, 2 clinicians

Practice addresses (Care Compare)

1411 N Flagler Dr
Suite 9000
West Palm Beach, FL 33401-3421
Phone (561) 584-8460

Hospital & facility affiliations

  • First Choice Home Health Inc Home health agency, Boynton Beach, FL, CCN 108183

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11008886FLMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adult and Pediatric Dermatology Practitioners P a CurrentSince Aug 1, 2021 Accepting new patients
Adult and Pediatric Dermatology Practitioners P a CurrentSince Aug 1, 2021 Accepting new patients
Jacob a Marder, DNP PA Dermatology CurrentSince May 25, 2023 Accepting new patients

Locations

8980 S US Highway 1
Ste 103
Port St Lucie, FL 34952
Phone (561) 406-9566

6100 SE Federal Hwy
Stuart, FL 34997
Phone (772) 600-7688

1411 N Flagler Dr
Ste 9000
West Palm Beach, FL 33401
Phone (561) 584-8460

35 Green Pond Rd
Ste C
Rockaway, NJ 07866
Phone (973) 208-8110

Organizations & group practices 3

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 1

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": "1598572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1154934149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 N FLAGLER DR STE 9000",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334013421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 N FLAGLER DR STE 9000",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334013421",
            "telephone_number": "561-584-8460",
            "fax_number": "561-935-5537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARDER",
        "first_name": "JACOB",
        "middle_name": "ARIEL",
        "name_prefix": "Dr.",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-28",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "APRN11008886",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11008886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACOB",
            "last_name": "MARDER",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.