Individual provider Active NPI

Marie E Duthil, M.D

  • Internal Medicine Physician
  • Pahokee, FL
National Provider Identifier
1720014566
Registry record updated Feb 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME0061252 Issued in FL
Practice address
279 S Lake Ave
Pahokee, FL 33476
Phone
(561) 446-4312
Fax
(866) 611-0620
NPI assigned
Jun 23, 2006
Last updated
Feb 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME0061252 FL Primary

Addresses

Primary practice location

279 S Lake Ave
Pahokee, FL 33476

Mailing address

279 S Lake Ave
Pahokee, FL 33476
Phone (561) 446-4312

Other practice location 1

1201 South Main St
Belle Glade, FL 33430
Phone (561) 996-6571 ext. 400

Other practice location 2

225 S Congress Ave
Delray Beach, FL 33445-4616
Phone (561) 642-1000

Other identifiers 1

IdentifierTypeStateIssuer
257949900MedicaidFL

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050427000083 FL Practitioner - Internal Medicine 0648219964

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

279 S Lake Ave
Pahokee, FL 33476-1843

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME0061252FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shekinah Family Medical Centers LLC Internal Medicine CurrentSince Mar 25, 2020 Accepting new patients

Locations

279 S Lake Ave
Pahokee, FL 33476
Phone (561) 285-9494

Interoperability endpoints

  • Direct secure messaging: marie.duthil@316.emedpractice.direct-ci.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582156800000",
    "number": "1720014566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "279 S LAKE AVE",
            "city": "PAHOKEE",
            "state": "FL",
            "postal_code": "33476",
            "telephone_number": "561-446-4312",
            "fax_number": "866-611-0620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "279 S LAKE AVE",
            "city": "PAHOKEE",
            "state": "FL",
            "postal_code": "33476",
            "telephone_number": "561-446-4312",
            "fax_number": "866-611-0620"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 South Main St",
            "address_purpose": "LOCATION",
            "city": "Belle Glade",
            "state": "FL",
            "postal_code": "33430",
            "country_code": "US",
            "telephone_number": "561-996-6571 x400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "225 S Congress Ave",
            "address_purpose": "LOCATION",
            "city": "Delray Beach",
            "state": "FL",
            "postal_code": "334454616",
            "country_code": "US",
            "telephone_number": "561-642-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUTHIL",
        "first_name": "MARIE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0061252",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "257949900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pahokee, FL

Sources for this page

Verify at the official NPI Registry.