Mark D. Ford, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS0007060 Issued in FL

Practice address

5130 Sunforest Dr Ste 300
Tampa, FL 33634-6327

Phone

(727) 824-0780

Fax

(813) 514-8891

NPI assigned

Apr 6, 2006

Last updated

Nov 23, 2021By 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 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, Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: mark.ford@wellmed.eclinicaldirectplus.com

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.

• CTD Network LLC

  • Multi-Specialty Clinic/Center
  • Plant City, FL
  • NPI 1851039762
  Medicare reassignment NPD Authorized official
• Optumcare Florida LLC

  dba Optum

  • General Practice Physician
  • Tampa, FL
  • NPI 1053384214

  Family Medicine

  Medicare reassignment NPD
• Wellmed Medical Management of Florida Inc

  • Family Medicine Physician
  • Port St Lucie, FL
  • NPI 1033395397
  Medicare reassignment NPD
• Optumcare Florida, LLC

  dba Optum

  • Hospitalist Physician
  • Tampa, FL
  • NPI 1659884294
  NPD
• Optumcare Florida Ci, LLC

  • Primary Care Clinic/Center
  • Winter Park, FL
  • NPI 1720506603
  NPD (past)

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1649232349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5130 SUNFOREST DR STE 300",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336346327",
            "telephone_number": "727-824-0780",
            "fax_number": "813-514-8891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5130 SUNFOREST DR STE 300",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336346327",
            "telephone_number": "727-824-0780",
            "fax_number": "813-514-8891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "MARK",
        "middle_name": "D.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS0007060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "251970400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donald Alan Ford, LMHC
• Heather Renee Ford, APRN
• Jaclyn Ford, CRNA
• Joann O Ford, APRN
• Kamisha Ford, BSW, MNPA
• Martha P Ford, D.O.
• Nathaniel Shawon Ford
• Phylicia Ford
• Sofia Ford, M.S.
• Steven Lee Ford, M.D.

• Family Medicine Physician in Tampa, FL
• Providers in Tampa, 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 Nov 23, 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.