Individual provider Active NPI

Roni K Marino, PA-C

  • Medical Physician Assistant
  • Bradenton, FL
National Provider Identifier
1356331417
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA3427 Issued in FL
Practice address
2424 Manatee Ave W Ste 100
Bradenton, FL 34205-4954
Phone
(941) 847-7920
Fax
(941) 757-2291
NPI assigned
Oct 28, 2005
Last updated
Oct 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA3427 FL Primary

Addresses

Primary practice location

2424 Manatee Ave W Ste 100
Bradenton, FL 34205-4954

Mailing address

2424 Manatee Ave W Ste 100
Bradenton, FL 34205-4954
Phone (941) 847-7920

Other identifiers 2

IdentifierTypeStateIssuer
001771100MedicaidFL
Y01TAOtherFLBCBS

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
I20100315000158 FL Practitioner - Physician Assistant 9335274505 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optumcare Florida, LLCGroup PAC ID 3072403476, 266 clinicians

Practice addresses (Care Compare)

2424 Manatee Ave W
100 Optum Riverfront
Bradenton, FL 34205-4954
Phone (941) 847-7920

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA3427FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Optumcare Florida LLC CurrentSince Sep 22, 2025 Accepting new patients
Optumcare Florida, LLC CurrentSince Sep 22, 2025 Accepting new patients

Locations

2424 Manatee Ave W
Ste 100
Bradenton, FL 34205
Phone (941) 847-7290

1989 W Lumsden Rd
Brandon, FL 33511
Phone (813) 653-3111

1345 West Bay Dr
Ste 202
Largo, FL 33770
Phone (727) 559-0895

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: roni.marino@wellmed.eclinicaldirectplus.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": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1356331417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2424 MANATEE AVE W STE 100",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342054954",
            "telephone_number": "941-847-7920",
            "fax_number": "941-757-2291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 MANATEE AVE W STE 100",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342054954",
            "telephone_number": "941-847-7920",
            "fax_number": "941-757-2291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINO",
        "first_name": "RONI",
        "middle_name": "K",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-28",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA3427",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001771100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y01TA",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.