Individual provider Active NPI

Dominic Marino, D.O.

  • Orthopaedic Surgery Physician
  • Daytona Beach, FL
National Provider Identifier
1225577703
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
OS18633 Issued in FL
Practice address
1865 Lpga Blvd
Daytona Beach, FL 32117-7108
Phone
(386) 255-4596
Fax
(386) 258-3561
NPI assigned
Feb 17, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X OS18633 FL Primary

Addresses

Primary practice location

1865 Lpga Blvd
Daytona Beach, FL 32117-7108

Mailing address

1865 Lpga Blvd
Daytona Beach, FL 32117-7108
Phone (386) 255-4596

Other practice location 1

1075 Mason Ave
Daytona Beach, FL 32117-4611
Phone (386) 255-4596

Other identifiers 1

IdentifierTypeStateIssuer
114003100MedicaidFL

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220711002143 FL Practitioner - Orthopedic Surgery 1759761521 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Lake Erie Col of Osteopathic Medicine, Bradenton, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians
Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians
Orthopaedic Clinic of Daytona Beach PAGroup PAC ID 9335123504, 48 clinicians

Practice addresses (Care Compare)

1200 Lexington Green LN
Sanford, FL 32771-1013

1865 Lpga Blvd
Daytona Beach, FL 32117-7108
Phone (386) 255-4596

Hospital & facility affiliations

  • Confident Care of Florida Corp Home health agency, Palm Coast, FL, CCN 108222
  • Halifax Health Medical Center Hospital, Daytona Beach, FL, CCN 100017
  • Adventhealth Daytona Beach Hospital, Daytona Beach, FL, CCN 100068
  • AdventHealth Palm Coast Hospital, Palm Coast, FL, CCN 100118
  • Adventhealth New Smyrna Beach Hospital, New Smyrna Beach, FL, CCN 100014

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement59
Knee replacement94
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS18633FLMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Musculoskeletal Institute Chartered Orthopaedic Surgery CurrentSince Jul 25, 2022 Accepting new patients
Musculoskeletal Institute Chartered Orthopaedic Surgery Current Accepting new patients
Orthopaedic Clinic of Daytona Beach PA Orthopaedic Surgery CurrentSince Aug 14, 2023 Accepting new patients
Orthopaedic Clinic of Daytona Beach PA Orthopaedic Surgery CurrentSince Aug 14, 2023 Accepting new patients
Musculoskeletal Institute Chartered Orthopaedic Surgery CurrentSince Jul 25, 2022 Accepting new patients

Locations

1890 Lpga Blvd
Ste 240
Daytona Beach, FL 32117
Phone (386) 255-4596

1075 Mason Ave
Daytona Beach, FL 32117
Phone (386) 255-4596

1865 Lpga Blvd
Daytona Beach, FL 32117
Phone (386) 255-4596

17 Old Kings Rd N
Ste K
Palm Coast, FL 32137
Phone (386) 255-4596

1165 Dunlawton Ave
Ste 102
Port Orange, FL 32127
Phone (386) 255-4596

1175 Dunlawton Ave
Ste 1
Port Orange, FL 32127
Phone (386) 255-4596

13020 N Telecom Pkwy
Fl Orthopaedic
Temple Terrace, FL 33637

13060 N Telecom Pkwy
Fl Orthopaedic
Temple Terrace, FL 33637

13020 N Telecom Pkwy
Temple Terrace, FL 33637

5901 E Fowler Ave
Ste 100
Temple Terrace, FL 33617
Phone (813) 987-9700

2044 Trinity Oaks Blvd
Ste 110
Trinity, FL 34655
Phone (813) 978-7000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10735/brand/1/csg/1/fhir/r4
  • Direct secure messaging: dominic.marino.1@10735.direct.athenahealth.com

Organizations & group practices 5

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 6

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": "1487289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1225577703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1865 LPGA BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321177108",
            "telephone_number": "386-255-4596",
            "fax_number": "386-258-3561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1865 LPGA BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321177108",
            "telephone_number": "386-255-4596",
            "fax_number": "386-258-3561"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1075 Mason Ave",
            "address_purpose": "LOCATION",
            "city": "Daytona Beach",
            "state": "FL",
            "postal_code": "321174611",
            "country_code": "US",
            "telephone_number": "386-255-4596",
            "fax_number": "386-258-3561",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARINO",
        "first_name": "DOMINIC",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-17",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "OS18633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114003100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.