Individual provider Active NPI

Marcus Ortiz, CAA

  • Anesthesiologist Assistant
  • Jacksonville, FL
National Provider Identifier
1396255378
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
75000174A Issued in IN
Practice address
1 Shircliff Way
Jacksonville, FL 32204-4748
Phone
(904) 308-7300
NPI assigned
Oct 4, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 75000174A IN Primary
Anesthesiologist Assistant 367H00000X AA410 FL

Addresses

Primary practice location

1 Shircliff Way
Jacksonville, FL 32204-4748

Mailing address

11763 Mandarin Forest Dr
Jacksonville, FL 32223-1792

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180118002504 FL Practitioner - Anesthesiology Assistant 4688933617 Reassigns benefits to 4 organizations
I20240326003680 IN Practitioner - Anesthesiology Assistant 4688933617 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brevard Physician Associates PLLCGroup PAC ID 1850535048, 221 clinicians
US Anesthesia Partners of Florida IncGroup PAC ID 0345143152, 1,111 clinicians

Practice addresses (Care Compare)

1350 Hickory St
Melbourne, FL 32901-3224
Phone (321) 434-7000

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

Hospital & facility affiliations

  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007
  • Viera Hospital Hospital, Melbourne, FL, CCN 100315

Merit-based Incentive Payment System (MIPS)

Final score
67.76 of 100Reported as group
Quality
62.07
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Sheridan Healthcorp Inc Anesthesiology CurrentSince Nov 1, 2021 Accepting new patients
Sheridan Healthcorp, Inc. Anesthesiology CurrentSince Nov 1, 2021 Accepting new patients
US Anesthesia Partners of Florida Inc. Anesthesiology CurrentSince Apr 22, 2022 Accepting new patients
Brevard Physician Associates, PLLC Anesthesiology CurrentSince Dec 8, 2022 Accepting new patients
Sheridan Healthcorp Inc Anesthesiology Current Accepting new patients
Orlando Anesthesia Consultants PA Anesthesiology CurrentSince Sep 1, 2023 Accepting new patients
Associated Anesthesiologists of Fort Wayne PC Anesthesiology CurrentSince Mar 21, 2024 Accepting new patients
Brevard Physician Associates, PLLC CurrentSince Dec 8, 2022 Accepting new patients

Locations

1900 Don Wickham Dr
Clermont, FL 34711
Phone (352) 536-8761

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

4500 Newberry Rd
Gainesville, FL 32607
Phone (352) 367-2310

2275 N Central Ave
Kissimmee, FL 34741
Phone (407) 570-0573

1350 Hickory St
Melbourne, FL 32901
Phone (321) 434-1771

201 Mohawk Rd
Minneola, FL 34715
Phone (973) 979-9079

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

88 W Kaley St
Orlando, FL 32806
Phone (407) 423-0573

1401 W Seminole Blvd
Sanford, FL 32771
Phone (317) 805-2316

1613 NW 136th Ave
Ste 200
Sunrise, FL 33323
Phone (954) 838-2502

1000 Waterman Way
Tavares, FL 32778
Phone (352) 253-3333

1316 E 7th St
Auburn, IN 46706
Phone (260) 925-4600

10315 Dawsons Creek Blvd
Ste Ab
Fort Wayne, IN 46825
Phone (219) 436-7875

4023 Reas Ln
New Albany, IN 47150
Phone (502) 690-6425

12222 Merit Dr
Ste 600
Dallas, TX 75251
Phone (972) 361-1844

Organizations & group practices 8

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": "1507075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1396255378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11763 MANDARIN FOREST DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322231792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SHIRCLIFF WAY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044748",
            "telephone_number": "904-308-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ",
        "first_name": "MARCUS",
        "credential": "CAA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-04",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "IN",
            "license": "75000174A",
            "primary": true
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "FL",
            "license": "AA410",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.