Active NPI
Marlesa Anne Dodd-O, PA-C
- Physician Assistant
- Daytona Beach, FL
National Provider Identifier
1831543024
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA5633
- Practice address
- 305 Memorial Medical Pkwy Ste 206
Daytona Beach, FL 32117-5169 - Phone
- (386) 231-4450
- Fax
- (386) 231-4459
- NPI assigned
- Apr 14, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA1160 | NH | |
| Physician Assistant | 363A00000X | PA5633 | MA | Primary |
Addresses
Primary practice location
305 Memorial Medical Pkwy Ste 206
Daytona Beach, FL 32117-5169
Mailing address
305 Memorial Medical Pkwy Ste 206
Daytona Beach, FL 32117-5169
Phone (386) 231-4450
Other practice location 1
250 Green St Ste 205
Gardner, MA 01440-1377
Phone (978) 632-0800
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: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231007000388 | FL | Practitioner - Physician Assistant | 3577853027 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ability Health Services, IncAbility Health Services and Rehabilitation LP
Practice addresses (Care Compare)
1055 Saxon Blvd
Orange City, FL 32763-8468
Phone (386) 917-5000
1200 Lexington Green LN
Sanford, FL 32771-1013
301 Memorial Medical Pkwy
Daytona Beach, FL 32117-5167
Phone (386) 231-6000
305 Memorial Medical Pkwy
Daytona Beach, FL 32117-5169
Hospital & facility affiliations
- Adventhealth Daytona Beach
- Adventhealth New Smyrna Beach
- Adventhealth Deland
- AdventHealth Palm Coast
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1160 | NH | MD | Clinical Social Worker |
| PA1160 | NH | MD | Physician Assistant |
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
Interoperability endpoints
- mdoddo1945793@adventhealth.direct-ci.com
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Daytona Beach, FL
- NPI 1780100529
FL
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- New Smyrna Beach, FL
- NPI 1871977942
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1460592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691107200000",
"number": "1831543024",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 MEMORIAL MEDICAL PKWY STE 206",
"city": "DAYTONA BEACH",
"state": "FL",
"postal_code": "321175169",
"telephone_number": "386-231-4450",
"fax_number": "386-231-4459"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 MEMORIAL MEDICAL PKWY STE 206",
"city": "DAYTONA BEACH",
"state": "FL",
"postal_code": "321175169",
"telephone_number": "386-231-4450",
"fax_number": "386-231-4459"
}
],
"practiceLocations": [
{
"address_1": "250 Green St Ste 205",
"address_purpose": "LOCATION",
"city": "Gardner",
"state": "MA",
"postal_code": "014401377",
"country_code": "US",
"telephone_number": "978-632-0800",
"fax_number": "978-632-0833",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DODD-O",
"first_name": "MARLESA",
"middle_name": "ANNE",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-14",
"last_updated": "2023-08-04",
"certification_date": "2023-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NH",
"license": "PA1160",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MA",
"license": "PA5633",
"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 Aug 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.