Individual provider Active NPI

Mark S Saglibene, PAC

  • Physician Assistant
  • Clearwater, FL
National Provider Identifier
1730110420
Registry record updated May 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9102458 Issued in FL
Practice address
855 S Highland Ave
Clearwater, FL 33756-4446
Phone
(727) 219-1833
Fax
(727) 330-2908
NPI assigned
Jul 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9102458 FL Primary

Addresses

Primary practice location

855 S Highland Ave
Clearwater, FL 33756-4446

Mailing address

855 S Highland Ave
Clearwater, FL 33756-4446
Phone (727) 219-1833

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060209000555 FL Practitioner - Physician Assistant 7416962675 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dedicated Senior Medical Center of Florida, LLC CurrentSince Jan 9, 2023 Accepting new patients
Dedicated Senior Medical Center of Florida, LLC Past Accepting new patients
Coastal Cardiology Consultants PA Past Accepting new patients
MPM Cardiology Services LLC Past Accepting new patients

Locations

855 S Highland Ave
Clearwater, FL 33756
Phone (727) 219-1833

4715 S Florida Ave
Lakeland, FL 33813
Phone (863) 209-7003

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683504000000",
    "number": "1730110420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 S HIGHLAND AVE",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337564446",
            "telephone_number": "727-219-1833",
            "fax_number": "727-330-2908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 S HIGHLAND AVE",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337564446",
            "telephone_number": "727-219-1833",
            "fax_number": "727-330-2908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAGLIBENE",
        "first_name": "MARK",
        "middle_name": "S",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9102458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.