Individual provider Active NPI

Mark P Stuart, D.O.

  • Cardiovascular Disease Physician
  • Winter Garden, FL
National Provider Identifier
1447243977
Registry record updated Jan 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
OS11927 Issued in FL
Practice address
17000 Porter Rd Ste 201
Winter Garden, FL 34787-8915
Phone
(321) 841-6444
Fax
(407) 290-2118
NPI assigned
Aug 30, 2005
Last updated
Jan 6, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MS012107 MI
Cardiovascular Disease Physician 207RC0000X OS11927 FL Primary

Addresses

Primary practice location

17000 Porter Rd Ste 201
Winter Garden, FL 34787-8915

Mailing address

17000 Porter Rd Ste 201
Winter Garden, FL 34787-8915
Phone (321) 841-6444

Other identifiers 9

IdentifierTypeStateIssuer
310F337240OtherMIBCBSM CMG
116310900MedicaidFL
4568835MedicaidMI
3524264MedicaidMI
123909OtherMICARE CHOICES
0F31072OtherMIBCBSM COMMON PROV ID #
C6854OtherMIM-CARE
G85155OtherMIHEALTH ALLIANCE PLAN
5630545OtherMIBCBSM

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address markstuart@migra.allscriptsdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040304001257 MI Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Thoracic SurgeryPractitioner - Internal Medicine 7618865486 Reassigns benefits to 2 organizations
I20230320000121 FL Practitioner - Interventional Cardiology 7618865486 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Cardiology
Education
Michigan State University College of Osteopathic Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

17000 Porter Rd
Suite 201
Winter Garden, FL 34787-8915
Phone (321) 841-6444

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS11927FLMDCardiovascular Disease Physician
MS012107MIMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince Jan 1, 2023 Accepting new patients
Henry Ford Health Rochester Hospital Cardiovascular Disease CurrentSince Aug 30, 2017 Accepting new patients
Orlando Health Medical Group Inc Cardiovascular Disease CurrentSince Jan 1, 2023 Accepting new patients
Genesys Practice Partners Inc Current Accepting new patients
Genesys Practice Partners Inc Past Accepting new patients
Heart Care PC Cardiovascular Disease PastSince Aug 28, 2021 Accepting new patients

Locations

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

17000 Porter Rd
Ste 201
Winter Garden, FL 34787
Phone (407) 296-1871

1460 N Center Rd
Burton, MI 48509
Phone (810) 424-2011

1 Genesys Pkwy
Grand Blanc, MI 48439
Phone (810) 606-5733

1 Genesys Pkwy
Ste 3452
Grand Blanc, MI 48439
Phone (248) 849-2600

1101 W University Dr
Rochester Hls, MI 48307
Phone (248) 601-4805

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20439/brand/1/csg/1/fhir/r4

Organizations & group practices 6

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 4

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": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672963200000",
    "number": "1447243977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 PORTER RD STE 201",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347878915",
            "telephone_number": "321-841-6444",
            "fax_number": "407-290-2118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17000 PORTER RD STE 201",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347878915",
            "telephone_number": "321-841-6444",
            "fax_number": "407-290-2118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUART",
        "first_name": "MARK",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-30",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "MS012107",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "OS11927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM CMG",
            "identifier": "310F337240",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116310900",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4568835",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3524264",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE CHOICES",
            "identifier": "123909",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM COMMON PROV ID #",
            "identifier": "0F31072",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "M-CARE",
            "identifier": "C6854",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE PLAN",
            "identifier": "G85155",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "5630545",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "markstuart@migra.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "3452 Genesys Pkwy",
            "city": "Grand Blanc",
            "state": "MI",
            "country_code": "US",
            "postal_code": "484397334",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winter Garden, FL

Sources for this page

Verify at the official NPI Registry.