Individual provider Active NPI

Mary Bridget Hart, MD

  • Nuclear Medicine Physician
  • Orlando, FL
National Provider Identifier
1164437455
Registry record updated Jun 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nuclear Medicine PhysicianTaxonomy code 207U00000X
License
ME0064493 Issued in FL
Practice address
1400 S Orange Ave
Orlando, FL 32806-2134
Phone
(407) 648-3800
Fax
(407) 425-5203
NPI assigned
Jul 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2010

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Radiology Physician 2085N0904X ME0064493 FL
Diagnostic Radiology Physician 2085R0202X ME0064493 FL
Therapeutic Radiology Physician 2085R0203X ME0064493 FL
Nuclear Medicine Physician 207U00000X ME0064493 FL Primary

Addresses

Primary practice location

1400 S Orange Ave
Orlando, FL 32806-2134

Mailing address

1400 S Orange Ave
Orlando, FL 32806-2134
Phone (407) 648-3800

Other identifiers 4

IdentifierTypeStateIssuer
360003245OtherMEDICARE RR
23058OtherFLBCBS
3805400OtherUNITED HEALTH CARE
373223100MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051019000332 FL Practitioner - Nuclear Medicine 2567488539 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0064493FLMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Cancer Specialists & Research Institute, LLC Diagnostic Radiology CurrentSince Apr 1, 2021 Accepting new patients
Advanced Imaging, LLP Diagnostic Radiology Past Accepting new patients
Clearwater Imaging Associates PA Nuclear Radiology Past Accepting new patients
Premier Radiology, LLP Diagnostic Radiology Past Accepting new patients

Locations

4371 Veronica S Shoemaker Blvd
Fort Myers, FL 33916
Phone (239) 432-8500

3840 Broadway
Fort Myers, FL 33901
Phone (239) 275-6400

1970 Golf St
Fl Cancer
Sarasota, FL 34236
Phone (941) 795-3780

4420 Sun N Lake Blvd
Fl Cancer
Sebring, FL 33872
Phone (863) 385-1244

8787 Bryan Dairy Rd
Seminole, FL 33777
Phone (727) 391-4758

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277078400000",
    "number": "1164437455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 S ORANGE AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062134",
            "telephone_number": "407-648-3800",
            "fax_number": "407-425-5203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S ORANGE AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062134",
            "telephone_number": "407-648-3800",
            "fax_number": "407-425-5203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HART",
        "first_name": "MARY",
        "middle_name": "BRIDGET",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-29",
        "last_updated": "2010-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "FL",
            "license": "ME0064493",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME0064493",
            "primary": false
        },
        {
            "code": "2085R0203X",
            "taxonomy_group": "",
            "desc": "Radiology, Therapeutic Radiology",
            "state": "FL",
            "license": "ME0064493",
            "primary": false
        },
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "FL",
            "license": "ME0064493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "360003245",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "23058",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "3805400",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "373223100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.