Mark C Deluca, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

ME98849 Issued in FL

Practice address

11903 Southern Blvd
Suite 104
Royal Palm Beach, FL 33411-7644

Phone

(561) 333-8884

NPI assigned

Jun 5, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Dec 20, 2013 through Dec 20, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384905600000",
    "number": "1396947982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11903 SOUTHERN BLVD",
            "address_2": "SUITE 104",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "334117644",
            "telephone_number": "561-333-8884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11903 SOUTHERN BLVD",
            "address_2": "SUITE 104",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "334117644",
            "telephone_number": "561-333-8884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELUCA",
        "first_name": "MARK",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-05",
        "last_updated": "2013-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101242224",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME98849",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "243964",
            "primary": false
        },
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "NY",
            "license": "243964",
            "primary": false
        },
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "VA",
            "license": "0101242224",
            "primary": false
        },
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "FL",
            "license": "ME98849",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy M Decanio, D.C.
• Emily Deem, LMHC
• Angela Defabrique, DMD
• J'Nelle Delica, DMD, MPH
• Delta Health Group Inc
• Deluxe Private Nursing LLC.
• Landy Claire Delva, LMFT
• Dent-All Associates, Inc.
• Dentists of Royal Palm, PA
• Maureen Elie Derius

• Psychiatry Physician in Royal Palm Beach, FL
• Providers in Royal Palm Beach, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.