NPIMap

Individual provider Active NPI

Mark J Tenholder, MD PA

  • Orthopaedic Surgery Physician
  • Fort Walton Beach, FL
National Provider Identifier
1407850878
Registry record updated Jun 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
ME89699 Issued in FL
Practice address
1034 Mar Walt Dr Ste 100
Fort Walton Beach, FL 32547-6645
Phone
(850) 863-2153
Fax
(850) 863-2885
NPI assigned
Jun 13, 2005
Last updated
Jun 14, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X ME89699 FL Primary

Addresses

Primary practice location

1034 Mar Walt Dr Ste 100
Fort Walton Beach, FL 32547-6645

Mailing address

1034 Mar Walt Dr Unit 100
Fort Walton Beach, FL 32547-6637
Phone (850) 863-2153

Other identifiers 2

IdentifierTypeStateIssuer
37804OtherFLBLUE CROSS BLUE SHIELD FL
ATN 606147MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041014000670 FL Practitioner - Orthopedic Surgery 9638139843 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Florida College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Florida Surgeons PAGroup PAC ID 2769381391, 336 clinicians

Practice addresses (Care Compare)

1034 Mar Walt Dr
Fort Walton Beach, FL 32547-6645
Phone (850) 344-1646

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.79 of 100Reported as group
Quality
64.42
Promoting interoperability
100
Improvement activities
40
Cost
74.88

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement19
Knee replacement88
Lower limb (leg) arthroscopy (minimally invasive joint repair)17
Upper limb (arm) arthroscopy (minimally invasive joint repair)21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Associates PA Orthopaedic Surgery CurrentSince Apr 8, 2010 Accepting new patients
Orthopaedic Associates, PA Orthopaedic Surgery CurrentSince Apr 8, 2010 Accepting new patients
North Florida Surgeons, PA Orthopaedic Surgery CurrentSince May 19, 2024 Accepting new patients
North Florida Surgeons, PA CurrentSince May 19, 2024 Accepting new patients
Mark J Tenholder MD PA Orthopaedic Surgery PastSince Aug 1, 2004 Accepting new patients

Locations

5300 S Ferdon Blvd
Crestview, FL 32536
Phone (850) 344-1646

36468 Emerald Coast Pkwy
Ste 1101
Destin, FL 32541
Phone (850) 290-2154

36474C Emerald Coast Pkwy
Ste 3101
Destin, FL 32541
Phone (850) 344-1646

1340 S 18th St
Ste 104
Fernandina Beach, FL 32034
Phone (904) 277-3277

1034 Mar Walt Dr
Ft Walton Bch, FL 32547
Phone (850) 344-1646

1034 Mar Walt Dr
Unit 100
Ft Walton Bch, FL 32547
Phone (850) 315-9210

11945 San Jose Blvd
Ste 102
Jacksonville, FL 32223
Phone (904) 268-3937

554 Twin Cities Blvd
Ste D
Niceville, FL 32578
Phone (850) 315-9210

Interoperability endpoints

  • Direct secure messaging: mark.tenholder.1@9109.direct.athenahealth.com
  • Direct secure messaging: mtenholder@direct.orthoassociates.net

Organizations & group practices 5

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.

Hospital & facility affiliations 8

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": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465862400000",
    "number": "1407850878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 MAR WALT DR UNIT 100",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476637",
            "telephone_number": "850-863-2153",
            "fax_number": "850-863-2885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 MAR WALT DR STE 100",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476645",
            "telephone_number": "850-863-2153",
            "fax_number": "850-863-2885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENHOLDER",
        "first_name": "MARK",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2016-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "ME89699",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD FL",
            "identifier": "37804",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ATN 606147",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

Verify at the official NPI Registry.