Organization Active NPI

Mark W. Gocke MD, PA

  • Internal Medicine Physician
  • Jupiter, FL
National Provider Identifier
1174746085
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME58960 Issued in FL
Legal business name
MARK W. GOCKE MD, PA
Practice address
1025 Military TRL
Suite 113
Jupiter, FL 33458-7040
Phone
(561) 354-1002
Fax
(561) 354-1003
NPI assigned
Apr 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Karen Barlow
Title
Owner Billing Company
Phone
(561) 748-2889

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X ME58960 FL Primary

Addresses

Primary practice location

1025 Military TRL
Suite 113
Jupiter, FL 33458-7040

Mailing address

1025 Military TRL
Suite 113
Jupiter, FL 33458-7040
Phone (561) 354-1002

Other identifiers 1

IdentifierTypeStateIssuer
ME58960OtherFLSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110420000094 FL Part B Supplier - Clinic/Group Practice 1153506019 Practice locations: Palm Beach Gardens, FL

National Provider Directory

National Provider Directory

Locations

6415 Lake Worth Rd
Ste 102
Greenacres, FL 33463
Phone (561) 327-6977

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174746085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 MILITARY TRL",
            "address_2": "SUITE 113",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334587040",
            "telephone_number": "561-354-1002",
            "fax_number": "561-354-1003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 MILITARY TRL",
            "address_2": "SUITE 113",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334587040",
            "telephone_number": "561-354-1002",
            "fax_number": "561-354-1003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK W. GOCKE MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BARLOW",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "OWNER BILLING COMPANY",
        "authorized_official_telephone_number": "561-748-2889"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME58960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "ME58960",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jupiter, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.