Active NPI
Marykate H Vellis, PA-C
- Medical Physician Assistant
- Gainesville, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA2618
- Practice address
- 6420 W Newberry Rd
East Wing, Suite 100
Gainesville, FL 32605-4308 - Phone
- (352) 332-3900
- Fax
- (352) 332-5009
- NPI assigned
- Nov 15, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA2618 | FL | Primary |
Addresses
Primary practice location
6420 W Newberry Rd
East Wing, Suite 100
Gainesville, FL 32605-4308
Mailing address
PO Box 102222
Atlanta, GA 30368-2222
Phone (239) 274-8200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110832000 | Medicaid | FL |
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
6420 W Newberry Rd E Wing
1 Florida Cancer Specialists P L
Gainesville, FL 32605-4308
Phone (352) 332-3900
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA2618 | FL | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Cancer Specialists & Research Institute, LLC | Current | Accepting new patients | |
| Florida Cancer Specialists & Research Institute, LLC | Past | Accepting new patients | |
| Robert R Carroll MD PA | Past | Accepting new patients |
Locations
4371 Veronica S Shoemaker Blvd
Fort Myers, FL 33916
Phone (239) 432-8500
6420 W Newberry Rd
Ste 100
Gainesville, FL 32605
Phone (352) 332-3900
795 SW State Road 47
Lake City, FL 32025
Phone (386) 401-7066
1970 Golf St
Fl Cancer
Sarasota, FL 34236
Phone (941) 795-3780
460 N Orlando Ave
Ste 200
Winter Park, FL 32789
Phone (407) 898-5452
Organizations & group practices 3
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.
-
- Medical Oncology Physician
- Cape Coral, FL
- NPI 1760590962
-
- Medical Oncology Physician
- Bradenton, FL
- NPI 1508973231
-
- Non-Pharmacy Dispensing Site
- Gainesville, FL
- NPI 1780683730
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Gainesville, FL
- NPI 1174579155
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783641600000",
"number": "1720060833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 102222",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303682222",
"telephone_number": "239-274-8200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6420 W NEWBERRY RD",
"address_2": "EAST WING, SUITE 100",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326054308",
"telephone_number": "352-332-3900",
"fax_number": "352-332-5009"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VELLIS",
"first_name": "MARYKATE",
"middle_name": "H",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-15",
"last_updated": "2026-07-10",
"certification_date": "2026-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "FL",
"license": "PA2618",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110832000",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2026; 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.