Individual provider Active NPI

Joseph Marini, PA-C

  • Medical Physician Assistant
  • Port Saint Lucie, FL
National Provider Identifier
1215446380
Registry record updated Jan 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9110647 Issued in FL
Practice address
537 NW Lake Whitney PL Ste 103-106
Port Saint Lucie, FL 34986-1620
Phone
(772) 877-8578
NPI assigned
Sep 21, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9110647 FL Primary

Addresses

Primary practice location

537 NW Lake Whitney PL Ste 103-106
Port Saint Lucie, FL 34986-1620

Mailing address

3283 SE Quay Street
Port Saint Lucie, FL 34984
Phone (772) 233-6832

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
I20171212000022 FL Practitioner - Physician Assistant 2163780628 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospital Medicine Services of FL, LLCGroup PAC ID 9234596743, 513 clinicians

Practice addresses (Care Compare)

1796 US Hwy 441 N
Raulerson Hospital
Okeechobee, FL 34972-1918
Phone (863) 763-2151

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9110647FLMDMedical Physician Assistant

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 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": "1505952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1215446380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3283 SE QUAY STREET",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "34984",
            "telephone_number": "772-233-6832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "537 NW LAKE WHITNEY PL STE 103-106",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349861620",
            "telephone_number": "772-877-8578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINI",
        "first_name": "JOSEPH",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-21",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9110647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

Verify at the official NPI Registry.