Mark a. Nowacki MD PA

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

ME60591 Issued in FL

Legal business name

MARK A. NOWACKI MD PA

Practice address

7011 1St Ave S
Saint Petersburg, FL 33707-1203

Phone

(727) 347-4158

Fax

(727) 345-2260

NPI assigned

Mar 3, 2015

Last updated

Apr 4, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mark A Nowacki, M.DNPI 1710076138

Title

Physician

Phone

(727) 347-4158

Specialties & licenses 1

Addresses

Other identifiers 1

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

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark A Nowacki, MD

  • Internal Medicine Physician
  • St Petersburg, FL
  • NPI 1710076138
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1425340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712188800000",
    "number": "1427440213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7011 1ST AVE S",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337071203",
            "telephone_number": "727-347-4158",
            "fax_number": "727-345-2260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7011 1ST AVE S",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337071203",
            "telephone_number": "727-347-4158",
            "fax_number": "727-345-2260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK A. NOWACKI MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-03",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A",
        "authorized_official_last_name": "NOWACKI",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "727-347-4158",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "FL",
            "license": "ME60591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "372504900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maries Heartbeats LLC
• Marimar Manor
• Pedro Antonio Marin Garcia, SA-C, RMA
• Elizabeth Marie Marinelli, APRN
• Maritime ER SVCS Partnership LLC
• Mark Gallant DC LLC
• Mark Muse Counseling, LLC
• Mark T Howell DO PA
• Byron Paul Markel, M.D.
• Melissa Markel, FNP-C

• Preferred Provider Organization in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Preferred Provider Organization in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 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.