Individual provider Active NPI

Kendall Karen Marotti, P.A.

  • Surgical Physician Assistant
  • Port Charlotte, FL
National Provider Identifier
1457900862
Registry record updated Sep 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
9112459 Issued in FL
Practice address
1641 Tamiami TRL
Port Charlotte, FL 33948-1018
Phone
(941) 629-6262
Fax
(941) 629-1782
NPI assigned
Sep 9, 2019
Last updated
Sep 9, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 9112459 FL Primary

Addresses

Primary practice location

1641 Tamiami TRL
Port Charlotte, FL 33948-1018

Mailing address

1641 Tamiami TRL
Port Charlotte, FL 33948-1018
Phone (941) 629-6262

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191009001218 FL Practitioner - Physician Assistant 1052642857 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nokomis Physical Therapy LLCGroup PAC ID 8628240843, 104 clinicians
Schofield Hand and Bright Orthopaedics PLLCGroup PAC ID 8224129499, 6 clinicians
Empath Therapies LLCGroup PAC ID 5496144529, 108 clinicians

Practice addresses (Care Compare)

109 Laurel Rd E
Nokomis, FL 34275-5233
Phone (941) 375-8734

1950 Arlington St
Sarasota, FL 34239-3506
Phone (941) 921-2600

3600 William Penn Way
Venice, FL 34293-5236
Phone (941) 483-0746

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9112459FLMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Orthopedic Center of Charlotte County, PA CurrentSince Sep 23, 2019 Accepting new patients
Advanced Orthopedic Center of Charlotte County, PA PastSince Sep 15, 2019 Accepting new patients

Locations

1641 Tamiami Trl
Ste 1
Pt Charlotte, FL 33948
Phone (941) 629-6262

Interoperability endpoints

  • Direct secure messaging: kendallm@aocc1855.srs-direct.com
  • Direct secure messaging: kmarotti@aoc.emadirect.md

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 1

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": "1567987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567987200000",
    "number": "1457900862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1641 TAMIAMI TRL",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339481018",
            "telephone_number": "941-629-6262",
            "fax_number": "941-629-1782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1641 TAMIAMI TRL",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339481018",
            "telephone_number": "941-629-6262",
            "fax_number": "941-629-1782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAROTTI",
        "first_name": "KENDALL",
        "middle_name": "KAREN",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-09",
        "last_updated": "2019-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "9112459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

Verify at the official NPI Registry.