Organization Active NPI

Heart Group PA

  • Interventional Cardiology Physician
  • Daytona Beach, FL
National Provider Identifier
1831142470
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
Legal business name
HEART GROUP PA
Practice address
311 N Clyde Morris Blvd
Suite 310
Daytona Beach, FL 32114-2781
Phone
(386) 257-6644
NPI assigned
May 17, 2006
Last updated
Feb 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Authorized official

Name
Mark B. Barettella, M.D.NPI 1720040488
Title
President
Phone
(386) 257-6644

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RI0011X Primary

Addresses

Primary practice location

311 N Clyde Morris Blvd
Suite 310
Daytona Beach, FL 32114-2781

Mailing address

PO Box 9254
Daytona Beach, FL 32120-9254
Phone (386) 290-7886

National Provider Directory

National Provider Directory

Locations

311 N Clyde Morris Blvd
Ste 310
Daytona Beach, FL 32114
Phone (386) 257-6644

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739232000000",
    "number": "1831142470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9254",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321209254",
            "telephone_number": "386-290-7886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 N CLYDE MORRIS BLVD",
            "address_2": "SUITE 310",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142781",
            "telephone_number": "386-257-6644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEART GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A",
        "authorized_official_last_name": "BARETTELLA",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-257-6644",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.