Individual provider Active NPI

Mark William White, M.D.

  • Surgery Physician
  • Daytona Beach, FL
National Provider Identifier
1477559631
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME75474 Issued in FL
Practice address
103 Memorial Medical Pkwy Ste 125
Daytona Beach, FL 32117-5672
Phone
(386) 274-0250
Fax
(386) 274-0269
NPI assigned
Jun 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X ME75474 FL Primary

Addresses

Primary practice location

103 Memorial Medical Pkwy Ste 125
Daytona Beach, FL 32117-5672

Mailing address

11945 San Jose Blvd
Ste 300
Jacksonville, FL 32223-1627
Phone (904) 396-1725

Other identifiers 2

IdentifierTypeStateIssuer
107281OtherFLFHCP
P01102622OtherFLRAILROAD MEDICARE

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
I20041019000283 FL Practitioner - General Surgery 2062472772 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of North Carolina at Chapel Hill School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Florida Surgeons PAGroup PAC ID 2769381391, 336 clinicians

Practice addresses (Care Compare)

1890 Lpga Blvd
Suite 250
Daytona Beach, FL 32117-7131
Phone (386) 274-0250

Hospital & facility affiliations

  • Adventhealth Daytona Beach Hospital, Daytona Beach, FL, CCN 100068
  • Halifax Health Medical Center Hospital, Daytona Beach, FL, CCN 100017
  • Adventhealth Deland Hospital, Deland, FL, CCN 100045
  • Adventhealth New Smyrna Beach Hospital, New Smyrna Beach, FL, CCN 100014
  • AdventHealth Palm Coast Hospital, Palm Coast, FL, CCN 100118

Merit-based Incentive Payment System (MIPS)

Final score
81.79 of 100Reported as group
Quality
64.42
Promoting interoperability
100
Improvement activities
40
Cost
74.88

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)11
Hernia repair (minimally invasive)23
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux19
Melanoma (skin cancer) excision12
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME75474FLMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Florida Surgeons, PA Surgery CurrentSince Aug 1, 2012 Accepting new patients
Halifax Healthcare Systems Inc Surgery CurrentSince Jun 1, 2007 Accepting new patients
North Florida Surgeons, PA CurrentSince Aug 1, 2012 Accepting new patients
Mark W White MD,LLC PastSince Aug 1, 2004 Accepting new patients

Locations

303 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 425-2285

103 Memorial Medical Pkwy
Ste 125
Daytona Beach, FL 32117
Phone (386) 274-0250

1890 Lpga Blvd
Ste 250
Daytona Beach, FL 32117
Phone (386) 274-0250

11945 San Jose Blvd
Ste 300
Jacksonville, FL 32223

11945 San Jose Blvd
Ste 102
Jacksonville, FL 32223
Phone (904) 268-3937

836 Prudential Dr
Ste 1001
Jacksonville, FL 32207
Phone (904) 398-0004

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: mark.white.1@9109.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 6

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": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1477559631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11945 SAN JOSE BLVD",
            "address_2": "STE 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322231627",
            "telephone_number": "904-396-1725",
            "fax_number": "904-396-4893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 MEMORIAL MEDICAL PKWY STE 125",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175672",
            "telephone_number": "386-274-0250",
            "fax_number": "386-274-0269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "MARK",
        "middle_name": "WILLIAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME75474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FHCP",
            "identifier": "107281",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01102622",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.