Mark S Psarakis, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME56500 Issued in FL

Practice address

2222 S Harbor City Blvd
Suite 430
Melbourne, FL 32901-5594

Phone

(321) 541-1777

Fax

(321) 725-5504

NPI assigned

Apr 20, 2006

Last updated

Sep 18, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Steward Medical Group, Inc

  • Specialist
  • Brighton, MA
  • NPI 1356654495

  FL

  Medicare reassignment NPD
• Steward Medical Group, Inc.

  • Urology Physician
  • Cocoa, FL
  • NPI 1104367630

  Internal Medicine

  NPD
• Osler Medical Inc

  • Multi-Specialty Clinic/Center
  • Melbourne, FL
  • NPI 1356308670
  NPD (past)
• Stewart and Stewart a Medical Corporation

  dba Stewart Medical Group

  • Family Medicine Physician
  • Alhambra, CA
  • NPI 1306058565

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410998400000",
    "number": "1508821588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 S HARBOR CITY BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329015594",
            "telephone_number": "321-541-1777",
            "fax_number": "321-725-5504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 S HARBOR CITY BLVD",
            "address_2": "SUITE 430",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329015594",
            "telephone_number": "321-541-1777",
            "fax_number": "321-725-5504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PSARAKIS",
        "first_name": "MARK",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2014-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME56500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "378804100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "110101297",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Justin Provo
• Robert John Pruneau, R.PH.
• Christian Cameron Prusinski, DO
• Christopher J Prusinski, DO
• Alexis Pryor
• Psychiatric Care Associates LLC
• Psychological Associates of Melbourne, Inc.
• Psychology Associates of Brevard PLC
• Publix Super Markets Inc (Publix Pharmacy #2089)
• Publix Super Markets Inc (Publix Pharmacy #0704)

• Internal Medicine Physician in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.