Mark David Fay, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT23874 Issued in FL

Practice address

465 Town Plaza Ave Ste B
Ponte Vedra, FL 32081-5190

Phone

(904) 222-3780

Fax

(904) 306-5772

NPI assigned

Jun 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

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.

• Moreau Physical Therapy Inc.

  • Physical Therapist
  • Baton Rouge, LA
  • NPI 1770568669
  Medicare reassignment NPD
• Alvin C Moreau Jr Licensed Physical Therapist DTD 01 15 82

  • Physical Therapist
  • Beaumont, TX
  • NPI 1831962018
  NPD

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1750320172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 TOWN PLAZA AVE",
            "address_2": "SUITE B",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "32081",
            "telephone_number": "904-222-3780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 TOWN PLAZA AVE STE B",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320815190",
            "telephone_number": "904-222-3780",
            "fax_number": "904-306-5772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAY",
        "first_name": "MARK",
        "middle_name": "DAVID",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "04438",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "FL",
            "license": "PT23874",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT23874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Engelman, MA
• Caterina Therese Eppolito
• Etta Ettlinger, LCSW, PA
• Etta F. Ettlinger, LCSW
• David Falden, OD
• Femmewell Holdings LLC
• Naara Ferguson, RN
• Michael Filipkowski
• First Coast Home Care, LLC
• Five Star Physical Therapy

• Physical Therapist in Ponte Vedra, FL
• Providers in Ponte Vedra, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.