Mark Stephen McTammany, M.D.

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

ME0072191 Issued in FL

Practice address

1315 Valentine St
Melbourne, FL 32901-3127

Phone

(321) 768-7677

Fax

(321) 768-7756

NPI assigned

Jun 2, 2005

Last updated

May 18, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Steward Medical Group, Inc

  • Specialist
  • Brighton, MA
  • NPI 1356654495

  FL

  Medicare reassignment NPD
• Restorative Biotherapy PLLC

  • Multi-Specialty Clinic/Center
  • Melbourne, FL
  • NPI 1922691674
  Authorized official Same address or phone
• Steward Medical Group, Inc.

  • Urology Physician
  • Cocoa, FL
  • NPI 1104367630

  Obstetrics & Gynecology

  NPD
• Florida Department of Health

  dba Brevard County Health Department

  • Public Health or Welfare Agency
  • Viera, FL
  • NPI 1386751907
  NPD (past)
• Abilene Advanced Eyecare Inc.

  • Optometrist
  • Abilene, TX
  • NPI 1104001643
  NPD (past)
• Aeve, PA

  dba Advanced Eyecare & Vintage Eyewear

  • Optometrist
  • Abilene, TX
  • NPI 1083159800
  NPD (past)

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

{
    "created_epoch": "1117670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621296000000",
    "number": "1265434211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 VALENTINE ST",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013127",
            "telephone_number": "321-344-7677",
            "fax_number": "321-344-7678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 VALENTINE ST",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013127",
            "telephone_number": "321-768-7677",
            "fax_number": "321-768-7756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCTAMMANY",
        "first_name": "MARK",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-02",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME72191",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "FL",
            "license": "ME0072191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5510582",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "8653840",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "252532100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lee McNulty
• Christina McPherson
• John R McPherson, M.D.
• Bethany McQueen, FNP-BC
• Patrick McRae, APRN
• Abigail McWhorter
• MD Horizon Holdings, LLC
• MD Viera Healthcare, PA
• Anisa Ann Mead, FNP
• Breanne Leigh Meagher

• Gynecology Physician in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Gynecology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.