NPIMap

Individual provider Active NPI

Mark W. Lastarza, M.D.

  • Internal Medicine Physician
  • Ormond Beach, FL
National Provider Identifier
1831165448
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME0075627 Issued in FL
Practice address
335 Clyde Morris Blvd
Suite 290
Ormond Beach, FL 32174-5959
Phone
(386) 672-3219
Fax
(386) 672-3160
NPI assigned
Feb 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME0075627 FL Primary

Addresses

Primary practice location

335 Clyde Morris Blvd
Suite 290
Ormond Beach, FL 32174-5959

Mailing address

335 Clyde Morris Blvd
Suite 290
Ormond Beach, FL 32174-5959
Phone (386) 672-3219

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051026000449 FL Practitioner - Internal Medicine 8426075706 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Washington University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians
Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians
Adventhealth Primary Care Network IncGroup PAC ID 1557722410, 428 clinicians

Practice addresses (Care Compare)

1200 Lexington Green LN
Sanford, FL 32771-1013

1474 W Granada Blvd
Suite 455
Ormond Beach, FL 32174-8240
Phone (386) 231-4685

661 E Altamonte Dr
Suite 115
Altamonte Springs, FL 32701-5102
Phone (407) 831-4040

Hospital & facility affiliations

  • Trilogy Home Healthcare Home health agency, Jacksonville, FL, CCN 107689
  • Adventhealth Home Health Home health agency, Ormond Beach, FL, CCN 107408
  • Accentcare Home Health of Daytona Home health agency, Ormond Beach, FL, CCN 108284
  • Halifax Health Care at Home Home health agency, Port Orange, FL, CCN 108359
  • Apex Home Healthcare Home health agency, Ormond Beach, FL, CCN 107593
  • Adventhealth Daytona Beach Hospital, Daytona Beach, FL, CCN 100068
  • AdventHealth Palm Coast Hospital, Palm Coast, FL, CCN 100118
  • Adventhealth New Smyrna Beach Hospital, New Smyrna Beach, FL, CCN 100014
  • Halifax Health Medical Center Hospital, Daytona Beach, FL, CCN 100017
  • Adventhealth Palm Coast Parkway Hospital, Palm Coast, FL, CCN 100363

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0075627FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adventhealth Primary Care Network Inc Internal Medicine CurrentSince Nov 1, 2023 Accepting new patients
Coastal Internal Medicine Specialists LLC Internal Medicine Past Accepting new patients

Locations

661 E Altamonte Dr
Ste 115
Altamonte Springs, FL 32701
Phone (407) 831-4040

335 Clyde Morris Blvd
Ste 290
Ormond Beach, FL 32174
Phone (386) 672-3219

Interoperability endpoints

  • Direct secure messaging: mlastarza71838@adventhealth.direct-ci.com

Organizations & group practices 2

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.

Hospital & facility affiliations 11

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": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831165448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 CLYDE MORRIS BLVD",
            "address_2": "SUITE 290",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745959",
            "telephone_number": "386-672-3219",
            "fax_number": "386-672-3160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 CLYDE MORRIS BLVD",
            "address_2": "SUITE 290",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745959",
            "telephone_number": "386-672-3219",
            "fax_number": "386-672-3160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASTARZA",
        "first_name": "MARK",
        "middle_name": "W.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0075627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ormond Beach, FL

Sources for this page

Verify at the official NPI Registry.