Individual provider Active NPI

M Jeffrey Marcus, M.D.

  • Otolaryngic Allergy Physician
  • Inverness, FL
National Provider Identifier
1427057397
Registry record updated Jun 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngic Allergy PhysicianTaxonomy code 207YX0602X
License
ME20810 Issued in FL
Practice address
821 Medical CT E
Inverness, FL 34452-4623
Phone
(352) 726-3131
Fax
(888) 491-4367
NPI assigned
Jul 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngic Allergy Physician 207YX0602X ME20810 FL Primary
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X ME20810 FL

Addresses

Primary practice location

821 Medical CT E
Inverness, FL 34452-4623

Mailing address

821 Medical CT E
Inverness, FL 34452-4623
Phone (352) 726-3131

Other identifiers 3

IdentifierTypeStateIssuer
44142OtherFLBLUE CROSS
592023722OtherFLTAX ID
057682400MedicaidFL

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050520000410 FL Practitioner - OtolaryngologyPractitioner - Allergy/Immunology 8729029681

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20810FLMDMental Health Counselor
ME20810FLMDOtolaryngic Allergy Physician

NPI Registry JSON

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1427057397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 MEDICAL CT E",
            "city": "INVERNESS",
            "state": "FL",
            "postal_code": "344524623",
            "telephone_number": "352-726-3131",
            "fax_number": "888-491-4367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 MEDICAL CT E",
            "city": "INVERNESS",
            "state": "FL",
            "postal_code": "344524623",
            "telephone_number": "352-726-3131",
            "fax_number": "888-491-4367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCUS",
        "first_name": "M",
        "middle_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-21",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0602X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": "FL",
            "license": "ME20810",
            "primary": true
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "FL",
            "license": "ME20810",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "44142",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "592023722",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "057682400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Inverness, FL

Sources for this page

Verify at the official NPI Registry.