NPIMap

Individual provider Active NPI

Mario Marc Paese, DO

  • Interventional Pain Medicine Physician
  • Fort Lauderdale, FL
National Provider Identifier
1609436567
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
OS20311 Issued in FL
Practice address
6000 N Federal Hwy
Fort Lauderdale, FL 33308-2226
Phone
(954) 771-2551
NPI assigned
Jun 13, 2019
Last updated
Sep 6, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X OS20311 FL
Student in an Organized Health Care Education/Training Program 390200000X
Interventional Pain Medicine Physician 208VP0014X OS20311 FL Primary

Addresses

Primary practice location

6000 N Federal Hwy
Fort Lauderdale, FL 33308-2226

Mailing address

6000 N Federal Hwy
Fort Lauderdale, FL 33308-2226
Phone (954) 771-2551

Other identifiers 1

IdentifierTypeStateIssuer
270949204OtherFLNON-MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230808002502 FL Practitioner - Physical Medicine and Rehabilitation 4789046707 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Lincoln Mem Univ, Debusk Col of Osteopathic Med, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Holy Cross Hospital IncGroup PAC ID 1850298365, 299 clinicians

Practice addresses (Care Compare)

5601 N Dixie Hwy
Suite 209
Oakland Park, FL 33334-4145
Phone (954) 229-7962

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS20311FLMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Holy Cross Hospital, Inc CurrentSince Apr 22, 2024 Accepting new patients
Holy Cross Hospital Inc Interventional Pain Medicine CurrentSince Apr 22, 2024 Accepting new patients
Holy Cross Hospital, Inc. Interventional Pain Medicine Past Accepting new patients
Holy Cross Hospital Inc Past Accepting new patients
Holy Cross Hospital Inc Interventional Pain Medicine Past Accepting new patients
Holy Cross Hospital, Inc Past Accepting new patients

Locations

1309 S Federal Hwy
#G
Ft Lauderdale, FL 33316
Phone (954) 463-4383

5601 N Dixie Hwy
Ste 209
Oakland Park, FL 33334
Phone (954) 229-7962

Interoperability endpoints

  • Direct secure messaging: mario.paese.p1@direct.flaspinespecialists.nextgenshare.com
  • Direct secure messaging: mpaese3275197@direct.trinity-health.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1560384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1609436567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 N FEDERAL HWY",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333082226",
            "telephone_number": "954-771-2551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 N FEDERAL HWY",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333082226",
            "telephone_number": "954-771-2551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAESE",
        "first_name": "MARIO",
        "middle_name": "MARC",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-13",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "FL",
            "license": "OS20311",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "FL",
            "license": "OS20311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NON-MEDICARE",
            "identifier": "270949204",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.