Mark Edward Lamielle, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS12113 Issued in FL

Practice address

787 Cortaro Dr
Ruskin, FL 33573-6812

Phone

(813) 634-2500

Fax

(813) 634-3008

NPI assigned

Aug 10, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mark.lamielle.1@26845.direct.athenahealth.com
• Direct secure messaging: mlamielle105342@direct.tgh.org

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.

• Tampa General Medical Group Inc

  • Surgery Physician
  • Tampa, FL
  • NPI 1043557853
  Medicare reassignment NPD
• Tampa General Medical Group

  • Cardiac Rehabilitation Registered Nurse
  • Wimauma, FL
  • NPI 1013258748
  NPD

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1609877752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10051 5TH STREET NORTH",
            "address_2": "SUITE 200",
            "city": "ST. PETERSBURG",
            "state": "FL",
            "postal_code": "337022211",
            "telephone_number": "727-828-2370",
            "fax_number": "727-568-6011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "787 CORTARO DR",
            "city": "RUSKIN",
            "state": "FL",
            "postal_code": "335736812",
            "telephone_number": "813-634-2500",
            "fax_number": "813-634-3008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMIELLE",
        "first_name": "MARK",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34-00-4531",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS12113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0701280",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010843100",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mlamielle105342@direct.tgh.org",
            "affiliation": "N",
            "address_1": "16521 S US Highway 301",
            "city": "Wimauma",
            "state": "FL",
            "country_code": "US",
            "postal_code": "335982032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joshua Stephen Klasinski, PA-C
• Regy Geevarghese Korah, MD
• L.a.T Lab Solutions, LLC
• Alisha Ladha
• Lamercie Health Care, LLC
• Billy Lane, LAT, ATC
• Teresa Ivey Langley, ARNP
• Jaiden Langston
• Lavoia Adult Family Care Home LLC
• James X Lawrence, OD

• Family Medicine Physician in Ruskin, FL
• Providers in Ruskin, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.