Mar Primary Care LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

MAR PRIMARY CARE LLC

Practice address

2901 W Saint Isabel St Ste F
Tampa, FL 33607-6371

Phone

(813) 935-4744

NPI assigned

Oct 18, 2018

Organization subpart

No

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

Authorized official

Name

Meagan Christine Mane

Title

Cfo

Phone

(813) 935-4744

Specialties & licenses 2

Addresses

Other identifiers 5

Other names 1

• Citrus Medical Associates Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Mar Primary Care LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Mar Primary Care LLC

  • Internal Medicine Physician
  • Inverness, FL
  • NPI 1659049732
  NPD tax ID

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19044/brand/3/csg/1/fhir/r4

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Mar Primary Care LLC

  • Internal Medicine Physician
  • Inverness, FL
  • NPI 1659049732
  NPPES parent name

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Andrew Paul Barnes, DO

  • Internal Medicine Physician
  • Inverness, FL
  • NPI 1598256752
  Medicare reassignment Care Compare group NPD
• Gregory Rafael Disla, FNP-C

  • Family Nurse Practitioner
  • Inverness, FL
  • NPI 1376197541
  Medicare reassignment Care Compare group NPD
• Marcelo Alves Farias II

  • General Practice Physician
  • Plantation, FL
  • NPI 1114546108
  Medicare reassignment Care Compare group NPD
• Nelson Mane, MD, DC

  • Internal Medicine Physician
  • Tampa, FL
  • NPI 1568520971
  Medicare reassignment Care Compare group NPD
• Cheryl Bray, APRN

  • Family Nurse Practitioner
  • Inverness, FL
  • NPI 1336877745
  Medicare reassignment NPD
• Jairo Shigueru Kajimoto, AP

  • Acupuncturist
  • Tampa, FL
  • NPI 1356818140
  NPD
• Edwin S Ramos, APRN

  • Adult Health Nurse Practitioner
  • Tampa, FL
  • NPI 1376010405
  NPD
• Renee Christine Edwards Leichtfuss, D.C.

  • Chiropractor
  • Tampa, FL
  • NPI 1396125530
  NPD (past)
• Joseph Mane, DC

  • Chiropractor
  • Tampa, FL
  • NPI 1811438591
  NPD (past)

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

{
    "created_epoch": "1539820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606089600000",
    "number": "1417423344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 W SAINT ISABEL ST STE F",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076371",
            "telephone_number": "813-935-4744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 W SAINT ISABEL ST STE F",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076371",
            "telephone_number": "813-935-4744"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "216 S Seminole Ave",
            "address_purpose": "LOCATION",
            "city": "Inverness",
            "state": "FL",
            "postal_code": "344524738",
            "country_code": "US",
            "telephone_number": "352-560-0333",
            "fax_number": "352-560-0337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MAR PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-18",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A",
        "authorized_official_last_name": "MANE",
        "authorized_official_first_name": "MEAGAN",
        "authorized_official_middle_name": "CHRISTINE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "813-935-4744"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "JI8GZ",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "435I",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103843600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "6986186",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "7420970",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Citrus Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kaylee Maple, RBT
• Savannah Maples
• Andrea R Mapugay, PHARMD
• Lazara Dailes Maqueira, FNP
• Osvaldo Maqueira, ARNP
• Michelle Maracle
• Jason-Paul Sanjay Maragh, DO
• Morgan Marais, SW
• Barbara Ann Maraman
• Hossain M Marandi, M.D.

• Primary Care Clinic/Center in Tampa, FL
• Providers in Tampa, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; 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.