Individual provider Active NPI

Mark A. Daicoff, PA-C

  • Surgical Physician Assistant
  • St Petersburg, FL
National Provider Identifier
1184282907
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA9112118 Issued in FL
Practice address
601 7TH St S Ste 205
St Petersburg, FL 33701-4748
Phone
(727) 893-6235
Fax
(727) 553-7422
NPI assigned
Jun 5, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA9112118 FL Primary

Addresses

Primary practice location

601 7TH St S Ste 205
St Petersburg, FL 33701-4748

Mailing address

601 7TH St S Ste 205
St Petersburg, FL 33701-4748
Phone (727) 893-6235

Other practice location 1

4600 4th St N
St Petersburg, FL 33703-3802
Phone (727) 527-5272

Other identifiers 1

IdentifierTypeStateIssuer
125349000MedicaidFL

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
I20190806003086 FL Practitioner - Physician Assistant 3476880956 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohi West Medical Group LLCGroup PAC ID 2668882507, 200 clinicians

Practice addresses (Care Compare)

603 7TH St S
St Petersburg, FL 33701-4719

701 6TH St S
St Petersburg, FL 33701-4814
Phone (727) 823-1234

Hospital & facility affiliations

  • Orlando Health Bayfront Hospital Hospital, Saint Petersburg, FL, CCN 100032

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Musculoskeletal Institute Chartered CurrentSince Mar 9, 2021 Accepting new patients
Ohi West Medical Group, LLC CurrentSince Jan 13, 2025 Accepting new patients
Orlando Health, Inc. Current Accepting new patients

Locations

601 7th St S
Ste 205
St Petersburg, FL 33701
Phone (727) 893-6234

701 6th St S
St Petersburg, FL 33701
Phone (727) 450-1144

13020 N Telecom Pkwy
Fl Orthopaedic
Temple Terrace, FL 33637

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: mdaicoff189358@orlandohealth.medalliesdirect.net

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.

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": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1184282907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 7TH ST S STE 205",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014748",
            "telephone_number": "727-893-6235",
            "fax_number": "727-553-7422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 7TH ST S STE 205",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014748",
            "telephone_number": "727-893-6235",
            "fax_number": "727-553-7422"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4600 4th St N",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337033802",
            "country_code": "US",
            "telephone_number": "727-527-5272",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAICOFF",
        "first_name": "MARK",
        "middle_name": "A.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-05",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9112118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "125349000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.