NPIMap

Organization Active NPI

S S Marathe MD PA

Doing business as Medical Specialists PA

  • Nephrology Physician
  • Palatka, FL
National Provider Identifier
1487846382
Registry record updated Jun 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
S S MARATHE MD PA
Doing business as
Medical Specialists PA
Practice address
800 Zeagler Dr
Suite 510
Palatka, FL 32177-3883
Phone
(386) 325-2663
NPI assigned
Aug 14, 2007
Last updated
Jun 24, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2008

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

Authorized official

Name
Shriram Marathe, MD
Title
President
Phone
(904) 824-8158

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X NU Primary

Addresses

Primary practice location

800 Zeagler Dr
Suite 510
Palatka, FL 32177-3883

Mailing address

665 State Road 207
Suite 102
St Augustine, FL 32084-5938
Phone (904) 824-8158

Other identifiers 1

IdentifierTypeStateIssuer
250270402MedicaidFL

Other names 1

  • Medical Specialists PA Doing business as

National Provider Directory

National Provider Directory

Locations

3805 Crill Ave
Palatka, FL 32177
Phone (386) 328-1122

1 Florida Park Dr S
Ste 230
Palm Coast, FL 32137
Phone (386) 445-2003

4869 Palm Coast Pkwy NW
Unit 2
Palm Coast, FL 32137
Phone (385) 445-2003

1955 US Highway 1 S
Ste B6
Saint Augustine, FL 32086
Phone (904) 824-0956

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214265600000",
    "number": "1487846382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 STATE ROAD 207",
            "address_2": "SUITE 102",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320845938",
            "telephone_number": "904-824-8158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 ZEAGLER DR",
            "address_2": "SUITE 510",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321773883",
            "telephone_number": "386-325-2663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S S MARATHE MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-14",
        "last_updated": "2008-06-24",
        "status": "A",
        "authorized_official_last_name": "MARATHE",
        "authorized_official_first_name": "SHRIRAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-824-8158",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "250270402",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medical Specialists PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Palatka, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.