Active NPI
Mark C Witte, MD
- Otolaryngology Physician
- Tampa, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- ME133555
- Practice address
- 13330 Usf Laurel Dr
Tampa, FL 33612-6601 - Phone
- (813) 974-2201
- NPI assigned
- Dec 2, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 37269 | MN | |
| Otolaryngology Physician | 207Y00000X | ME133555 | FL | Primary |
Addresses
Primary practice location
13330 Usf Laurel Dr
Tampa, FL 33612-6601
Mailing address
PO Box 917770
Orlando, FL 32891-0001
Phone (813) 974-2201
Other practice location 1
2024 S 6th St
Brainerd, MN 56401-4529
Phone (218) 828-7100
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6EBRJ | Other | FL | BLUE CROSS BLUE SHIELD |
| 590223100 | Medicaid | MN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mwitte134057@direct.tgh.org |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Otolaryngology
- Education
- Johns Hopkins University School of Medicine, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
13330 Usf Laurel Dr
Suite 3
Tampa, FL 33612-6601
Phone (813) 974-4683
Hospital & facility affiliations
- Tampa General Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME133555 | FL | MD | Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tampa General Hospital | Current | Accepting new patients | |
| University Medical Service Association Inc | Current | Accepting new patients | |
| University Medical Service Association Inc | Otolaryngology | Current | Accepting new patients |
| University Medical Service Association Inc | Current | Accepting new patients | |
| St. Joseph'S Medical Center | Past | Accepting new patients | |
| University Medical Service Association Inc | Past | Accepting new patients |
Locations
13330 Usf Laurel Dr
Tampa, FL 33612
Phone (813) 396-9478
13330 Usf Laurel Dr
#3
Tampa, FL 33612
Phone (813) 974-4683
4202 E Fowler Ave
Stop SHS100
Tampa, FL 33620
Phone (813) 974-2331
12901 Bruce B Downs Blvd
#62
Tampa, FL 33612
13330 Usf Laurel Dr
Fl 3
Tampa, FL 33612
Phone (813) 396-9422
12901 Bruce B Downs Blvd
#19
Tampa, FL 33612
Phone (813) 844-4103
Networks
- Freedom Health HMO Network
Interoperability endpoints
- https://epicproxy.et0761.epichosted.com/FHIRProxy/api/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 and National Provider Directory roles.
-
- Physical Therapist
- Tampa, FL
- NPI 1992742324
-
- General Acute Care Hospital
- Tampa, FL
- NPI 1124558929
-
- Durable Medical Equipment & Medical Supplies
- Tampa, FL
- NPI 1194276576
-
- General Practice Physician
- Tampa, FL
- NPI 1326088295
Otolaryngology
-
- Neurological Surgery Physician
- Tampa, FL
- NPI 1740227966
-
- Primary Care Clinic/Center
- Pillager, MN
- NPI 1891740957
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Tampa, FL
- NPI 1235196510
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133481600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617148800000",
"number": "1477537348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 917770",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328910001",
"telephone_number": "813-974-2201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13330 USF LAUREL DR",
"city": "TAMPA",
"state": "FL",
"postal_code": "336126601",
"telephone_number": "813-974-2201"
}
],
"practiceLocations": [
{
"address_1": "2024 S 6th St",
"address_purpose": "LOCATION",
"city": "Brainerd",
"state": "MN",
"postal_code": "564014529",
"country_code": "US",
"telephone_number": "218-828-7100",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WITTE",
"first_name": "MARK",
"middle_name": "C",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-02",
"last_updated": "2021-03-31",
"certification_date": "2021-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "MN",
"license": "37269",
"primary": false
},
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "FL",
"license": "ME133555",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "6EBRJ",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "590223100",
"state": "MN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mwitte134057@direct.tgh.org",
"affiliation": "N",
"address_1": "13330 Usf Laurel Dr",
"city": "Tampa",
"state": "FL",
"country_code": "US",
"postal_code": "336126601",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.