Individual provider Active NPI

Marilyne Etienne, PA-C

  • Physician Assistant
  • Orlando, FL
National Provider Identifier
1265941710
Registry record updated Sep 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9110725 Issued in FL
Practice address
5979 Vineland Rd Ste 101
Orlando, FL 32819-7860
Phone
(407) 355-3120
Fax
(407) 355-3119
NPI assigned
Sep 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9110725 FL Primary
Surgical Physician Assistant 363AS0400X 9110725 FL

Addresses

Primary practice location

5979 Vineland Rd Ste 101
Orlando, FL 32819-7860

Mailing address

5979 Vineland Rd Ste 101
Orlando, FL 32819-7860
Phone (407) 355-3120

Other practice location 1

5555 E SR 44 Ste 2
Wildwood, FL 34785-8214
Phone (407) 355-3120 ext. 109

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
I20190312000228 FL Practitioner - Physician Assistant 3779822630 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cora Health Services IncGroup PAC ID 1759290992, shared by 21 NPIs, 1,125 clinicians
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
Steve Nguyen MD PAGroup PAC ID 9931295037, 9 clinicians

Practice addresses (Care Compare)

1050 Old Camp Rd
Suite 282
The Villages, FL 32162-1762
Phone (352) 693-3378

1200 Lexington Green LN
Sanford, FL 32771-1013

5979 Vineland Rd
Suite 101
Orlando, FL 32819-7860
Phone 4073553120109

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.57 of 100Reported as individual
Quality
93.76
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9110725FLMDSurgical Physician Assistant

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: marilyne.etienne.1@29657.direct.athenahealth.com

Organizations & group practices 1

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 3

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": "1506556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758844800000",
    "number": "1265941710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5979 VINELAND RD STE 101",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328197860",
            "telephone_number": "407-355-3120",
            "fax_number": "407-355-3119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5979 VINELAND RD STE 101",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328197860",
            "telephone_number": "407-355-3120",
            "fax_number": "407-355-3119"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5555 E SR 44 Ste 2",
            "address_purpose": "LOCATION",
            "city": "Wildwood",
            "state": "FL",
            "postal_code": "347858214",
            "country_code": "US",
            "telephone_number": "407-355-3120 x109",
            "fax_number": "407-355-3119",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ETIENNE",
        "first_name": "MARILYNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-28",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9110725",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "9110725",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.