Mark Nicholas Perenich, D.O.

Primary specialty

Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X

License

OS14036 Issued in FL

Practice address

6536 Gunn Hwy.
Tampa, FL 33625-3853

Phone

(813) 803-0029

Fax

(813) 949-8919

NPI assigned

Aug 13, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Electronic endpoints 1

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

Specialty

Orthopedic Surgery

Education

Philadelphia College of Osteopathic Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DFFCDD/Endpoint/DFFCDD

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.

• Spine Institute of Florida, PLLC

  • Orthopaedic Surgery of the Spine Physician
  • Tampa, FL
  • NPI 1154875284
  Medicare reassignment Authorized official
• Glaum & Cho M.D.S, P.a.

  • Allergy & Immunology Physician
  • Tampa, FL
  • NPI 1588649263
  NPD

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

{
    "created_epoch": "1281657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615852800000",
    "number": "1497060487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7702 STILL PARK CIR",
            "city": "ODESSA",
            "state": "FL",
            "postal_code": "335562263",
            "telephone_number": "813-803-0029",
            "fax_number": "813-949-8919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6536 GUNN HWY.",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336253853",
            "telephone_number": "813-803-0029",
            "fax_number": "813-949-8919"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4700 N Habana Ave Ste 505",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336147120",
            "country_code": "US",
            "telephone_number": "813-803-0029",
            "fax_number": "813-949-8919",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1501 S Pinellas Ave Ste G",
            "address_purpose": "LOCATION",
            "city": "Tarpon Springs",
            "state": "FL",
            "postal_code": "346891950",
            "country_code": "US",
            "telephone_number": "813-803-0029",
            "fax_number": "813-949-8919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERENICH",
        "first_name": "MARK",
        "middle_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-13",
        "last_updated": "2021-03-16",
        "certification_date": "2021-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "TX",
            "license": "Q3421",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "FL",
            "license": "OS14036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "VJSQK",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "OS14036",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103265500",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "support@tampabackinstitute.com",
            "affiliation": "N",
            "address_1": "6536 Gunn Hwy.",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336253853",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Chelsea Pereira, APRN
• Daniela Elizabeth Pereira, DO
• Virginia Perello, DMD
• Yaimara Caridad Perena Coro
• Ashley Perenich, PA-C
• Norma Perera
• Shauna Perera
• Kelly Cristina Perez Acosta
• Adrian Ernesto Perez Alejandro
• Yanet Perez Alonso

• Orthopaedic Surgery of the Spine Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• Orthopaedic Surgery of the Spine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.

Verify at the official NPI Registry.