Individual provider Active NPI

Marco Muniz, D.O., M.P.H.

  • Family Medicine Physician
  • St Augustine, FL
National Provider Identifier
1790800118
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS7754 Issued in FL
Practice address
400 Health Park Blvd
St Augustine, FL 32086-5784
Phone
(904) 819-5155
NPI assigned
Mar 21, 2007
Last updated
Dec 16, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS7754 FL Primary
Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X OS 7754 FL

Addresses

Primary practice location

400 Health Park Blvd
St Augustine, FL 32086-5784

Mailing address

841 Prudential Dr Ste 1400
Jacksonville, FL 32207-8364
Phone (904) 396-5682

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
I20041230000686 FL Practitioner - Family Practice 2860450202 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS7754FLMDFamily Medicine Physician
OS 7754FLMDPreventive Medicine/Occupational Environmental Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sheridan Emergency Physician Services Inc CurrentSince Mar 11, 2018 Accepting new patients
Sheridan Emergency Physician Services Inc CurrentSince Mar 11, 2018 Accepting new patients
Tenet-Solantic Joint Venture LLC PastSince Nov 22, 2010 Accepting new patients

Locations

1210 S Old Dixie Hwy
Jupiter, FL 33458
Phone (561) 743-5073

4600 SW 46th Ct
Ocala, FL 34474
Phone (352) 291-3000

Interoperability endpoints

  • Direct secure messaging: mmuniz743010@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.

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1790800118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "841 PRUDENTIAL DR STE 1400",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078364",
            "telephone_number": "904-396-5682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HEALTH PARK BLVD",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865784",
            "telephone_number": "904-819-5155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNIZ",
        "first_name": "MARCO",
        "name_prefix": "Dr.",
        "credential": "D.O., M.P.H.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS7754",
            "primary": true
        },
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "FL",
            "license": "OS 7754",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.