Organization Active NPI

Mark R Kaiser M D PA

  • Dermatology Physician
  • Stuart, FL
National Provider Identifier
1851480131
Registry record updated May 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
ME0062247 Issued in FL
Legal business name
MARK R KAISER M D PA
Practice address
301 SE Osceola St
Stuart, FL 34994-2227
Phone
(772) 286-7081
Fax
(772) 286-7785
NPI assigned
Oct 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2008

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

Authorized official

Name
Dr. Mark R Kaiser, MDNPI 1710171335
Title
Physician
Phone
(772) 286-7081

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X ME0062247 FL Primary

Addresses

Primary practice location

301 SE Osceola St
Stuart, FL 34994-2227

Mailing address

301 SE Osceola St
Stuart, FL 34994-2227
Phone (772) 286-7081

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080331000366 FL Part B Supplier - Clinic/Group Practice 4880770817 Receives reassigned benefits from 5 practitioners
Practice locations: Fort Pierce, FL; Port Saint Lucie, FL; Stuart, FL

National Provider Directory

National Provider Directory

Locations

3550 SW Corporate Pkwy
Palm City, FL 34990
Phone (772) 286-1844

1701 SE Tiffany Ave
Ste 101
Port Saint Lucie, FL 34952
Phone (772) 286-7081

301 SE Osceola St
Stuart, FL 34994
Phone (772) 286-7081

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209686400000",
    "number": "1851480131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 SE OSCEOLA ST",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942227",
            "telephone_number": "772-286-7081",
            "fax_number": "772-286-7785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 SE OSCEOLA ST",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942227",
            "telephone_number": "772-286-7081",
            "fax_number": "772-286-7785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK R KAISER M D PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2008-05-02",
        "status": "A",
        "authorized_official_last_name": "KAISER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "772-286-7081",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME0062247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2008; 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.