Mark C George, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA-620 Issued in AL

Practice address

15620 New Hampshire CT
Fort Myers, FL 33908-4168

Phone

(239) 768-2057

Fax

(239) 768-2133

NPI assigned

Apr 11, 2006

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

Medicare fee-for-service enrollment

Enrolled in FL, AL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: mark.george.1@4290.direct.athenahealth.com

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.

• Millennium Physician Group LLC

  • Family Medicine Physician
  • Fort Myers, FL
  • NPI 1811122880
  Medicare reassignment Care Compare group NPD
• Millennium Physician Group LLC

  • Family Medicine Physician
  • Brooksville, FL
  • NPI 1073131702
  NPD
• Gulfshore Dermatology, P.a.

  • Dermatology Physician
  • Fort Myers, FL
  • NPI 1205353687
  NPD (past)

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1679536510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "877-856-3774",
            "fax_number": "239-599-2612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15620 NEW HAMPSHIRE CT",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339084168",
            "telephone_number": "239-768-2057",
            "fax_number": "239-768-2133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "MARK",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AL",
            "license": "PA-620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina George
• Eva Vertes George, M.D.
• Jacob George, M.D.
• Jeff George
• Lisa George
• Shaqwan George
• Sherin Abraham George, PHARM D
• Susan George
• Heather Krysten Geraci, M.A. CCC-SLP
• Niobet Gerardo

• Medical Physician Assistant in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; 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.