Individual provider Active NPI

Jacob Ryan Marty, DO

  • Emergency Medicine Physician
  • Winter Garden, FL
National Provider Identifier
1295419844
Registry record updated Jul 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS23751 Issued in FL
Practice address
2000 Fowler Grove Blvd
Winter Garden, FL 34787-5050
Phone
(407) 614-0500
NPI assigned
Jun 14, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OS23751 FL Primary

Addresses

Primary practice location

2000 Fowler Grove Blvd
Winter Garden, FL 34787-5050

Mailing address

2501 N Orange Ave
Suite 235, Box 38
Orlando, FL 32804-4659

Other practice location 1

601 E Rollins St Ste 400
Orlando, FL 32803-1248
Phone (407) 303-5600

Other practice location 2

4633 Vineland Rd
Orlando, FL 32811-7339
Phone (407) 727-1100

Other practice location 3

7727 Lake Underhill Rd
Orlando, FL 32822-8224
Phone (407) 303-8110

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
I20230627000165 FL Order and Referring Only - Emergency MedicinePractitioner - Emergency Medicine 4880052638

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1643 NW 136 Ave
Sunrise, FL 33323-2857

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9065FLMDStudent in an Organized Health Care Education/Training Program

Interoperability endpoints

  • Direct secure messaging: jmarty1716800@adventhealth.direct-ci.com

Hospital & facility affiliations 2

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": "1686700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784764800000",
    "number": "1295419844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 N ORANGE AVE",
            "address_2": "SUITE 235, BOX 38",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328044659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 FOWLER GROVE BLVD",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347875050",
            "telephone_number": "407-614-0500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 E Rollins St Ste 400",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328031248",
            "country_code": "US",
            "telephone_number": "407-303-5600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4633 Vineland Rd",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328117339",
            "country_code": "US",
            "telephone_number": "407-727-1100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7727 Lake Underhill Rd",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328228224",
            "country_code": "US",
            "telephone_number": "407-303-8110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTY",
        "first_name": "JACOB",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-14",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "OS23751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Garden, FL

Sources for this page

Verify at the official NPI Registry.