Individual provider Active NPI

Marcos Thomas Colon, M.D.

  • Developmental - Behavioral Pediatrics Physician
  • Orlando, FL
National Provider Identifier
1265850341
Registry record updated Aug 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
License
ME144012 Issued in FL
Practice address
615 E Princeton St Ste 300
Orlando, FL 32803-1468
Phone
(407) 898-6005
Fax
(407) 898-7722
NPI assigned
Apr 4, 2014
Last updated
Aug 19, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 55975 TN
Pediatrics Physician 208000000X ME144012 FL
Developmental - Behavioral Pediatrics Physician 2080P0006X ME144012 FL Primary

Addresses

Primary practice location

615 E Princeton St Ste 300
Orlando, FL 32803-1468

Mailing address

615 E Princeton St Ste 300
Orlando, FL 32803-1468
Phone (407) 898-6005

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
I20200731001888 FL Practitioner - Pediatric Medicine 9436574803 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55975TNMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc Pediatrics CurrentSince Aug 17, 2020 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Aug 17, 2020 Accepting new patients

Locations

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

615 E Princeton St
Ste 104
Orlando, FL 32803
Phone (407) 303-1575

615 E Princeton St
Ste 300
Orlando, FL 32803
Phone (407) 228-4774

Interoperability endpoints

  • Direct secure messaging: mcolon20663@direct.vumc.org
  • Direct secure messaging: mcolon73918@adventhealth.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1396569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1265850341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 E PRINCETON ST STE 300",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031468",
            "telephone_number": "407-898-6005",
            "fax_number": "407-898-7722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 E PRINCETON ST STE 300",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031468",
            "telephone_number": "407-898-6005",
            "fax_number": "407-898-7722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLON",
        "first_name": "MARCOS",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-04",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "55975",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME144012",
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "FL",
            "license": "ME144012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.