Gary Lee Marder, D.O.

Primary specialty

Allergy PhysicianTaxonomy code 207KA0200X

License

OS4773 Issued in FL

Practice address

9580 S Federal Hwy
Port Saint Lucie, FL 34952-4217

Phone

(772) 335-1500

Fax

(772) 335-1116

NPI assigned

Jun 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Osteopathy

Practice roles

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.

• L a Vinas MD PA

  • Plastic Surgery Physician
  • West Palm Beach, FL
  • NPI 1679713473
  NPD (past)

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204588800000",
    "number": "1730117003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9580 S FEDERAL HWY",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349524217",
            "telephone_number": "772-335-1500",
            "fax_number": "772-335-1116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9580 S FEDERAL HWY",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349524217",
            "telephone_number": "772-335-1500",
            "fax_number": "772-335-1116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARDER",
        "first_name": "GARY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2008-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "FL",
            "license": "OS4773",
            "primary": true
        },
        {
            "code": "207KI0005X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Clinical & Laboratory Immunology",
            "state": "FL",
            "license": "OS4773",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "FL",
            "license": "OS4773",
            "primary": false
        },
        {
            "code": "207NI0002X",
            "taxonomy_group": "",
            "desc": "Dermatology, Clinical & Laboratory Dermatological Immunology",
            "state": "FL",
            "license": "OS4773",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "FL",
            "license": "OS4773",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "82760",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard J Manson, B.S.W. , CAP
• Mohammad Mansy
• Nikkisha Latoya Maragh, FNP
• Sandra Marcelus
• Shay Nicole Marchionne
• Sarah Opoku Marfo, DC
• Joseph Marini, PA-C
• Melissa Marino
• Vanessa Marius, APRN (FNP-BC)
• Mark J. Pamer, D.O., L.L.C.

• Allergy Physician in Port Saint Lucie, FL
• Providers in Port Saint Lucie, FL by specialty
• Allergy Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.