Individual provider Active NPI

Mark Steven Michaels, M.D.

  • Family Medicine Physician
  • St Augustine, FL
National Provider Identifier
1740546837
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME150948 Issued in FL
Practice address
304 Ashourian Ave Ste 105
Saint Augustine, FL 32092-5110
Phone
(904) 819-1006
Fax
(904) 819-1008
NPI assigned
Apr 3, 2012
Last updated
Apr 9, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME150948 FL Primary

Addresses

Primary practice location

304 Ashourian Ave Ste 105
Saint Augustine, FL 32092-5110

Mailing address

PO Box 100237
Gainesville, FL 32610-0237
Phone (352) 392-4541

Other practice location 1

1600 SW Archer Rd
Gainesville, FL 32610-5110
Phone (352) 392-4541

Other practice location 2

600 E Dixie Ave
Leesburg, FL 34748-5925
Phone (352) 392-4541

Other practice location 3

400 Health Park Blvd
St Augustine, FL 32086-5784
Phone (904) 819-5155

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
I20211210002482 FL Practitioner - Family Practice 5193945459 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Villages Regional Hospital Physician Services LLCGroup PAC ID 0244688893, 198 clinicians

Practice addresses (Care Compare)

10435 SE 170TH PL
Summerfield, FL 34491-8998
Phone (352) 255-3615

304 Ashourian Ave
Suite 105
Saint Augustine, FL 32092-5110
Phone (904) 819-1006

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME150948FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Flagler Professional Health Care Services, Inc. Family Medicine CurrentSince Jan 3, 2022 Accepting new patients
Flagler Professional Health Care Services, Inc. CurrentSince Jan 3, 2022 Accepting new patients
Villages Regional Hospital Physician Services LLC CurrentSince Apr 1, 2025 Accepting new patients
Flagler Professional Health Care Services, Inc. CurrentSince Oct 1, 2024 Accepting new patients

Locations

600 E Dixie Ave
Leesburg, FL 34748
Phone (352) 323-5090

33 Old Kings Rd N
Ste 3
Palm Coast, FL 32137
Phone (386) 445-1100

120 Palencia Village Dr
Saint Augustine, FL 32095
Phone (904) 819-3200

120 Palencia Village Dr
Ste 107
Saint Augustine, FL 32095
Phone (904) 819-3200

110 Health Park Blvd
St Augustine, FL 32086
Phone (904) 823-3401

304 Ashourian Ave
Ste 105
St Augustine, FL 32092
Phone (904) 819-1006

400 Health Park Blvd
St Augustine, FL 32086
Phone (904) 819-4300

70 Turin Ter
Ste 110
St Augustine, FL 32092
Phone (904) 819-7200

2570 Race Track Rd
Ste A
St Johns, FL 32259
Phone (904) 819-1005

10435 SE 170th Pl
Summerfield, FL 34491
Phone (352) 245-7788

Interoperability endpoints

  • Direct secure messaging: mmichaels741033@direct.shands.ufl.edu

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1333411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1740546837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100237",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100237",
            "telephone_number": "352-392-4541",
            "fax_number": "352-294-8519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 ASHOURIAN AVE STE 105",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320925110",
            "telephone_number": "904-819-1006",
            "fax_number": "904-819-1008"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 SW Archer Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326105110",
            "country_code": "US",
            "telephone_number": "352-392-4541",
            "fax_number": "352-294-8519",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 E Dixie Ave",
            "address_purpose": "LOCATION",
            "city": "Leesburg",
            "state": "FL",
            "postal_code": "347485925",
            "country_code": "US",
            "telephone_number": "352-392-4541",
            "fax_number": "352-294-8519",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 Health Park Blvd",
            "address_purpose": "LOCATION",
            "city": "St Augustine",
            "state": "FL",
            "postal_code": "320865784",
            "country_code": "US",
            "telephone_number": "904-819-5155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MICHAELS",
        "first_name": "MARK",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-03",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME150948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.