Individual provider Active NPI

Peter M Marzano III, MD

  • Internal Medicine Physician
  • Melbourne, FL
National Provider Identifier
1861473167
Registry record updated Apr 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME79178 Issued in FL
Practice address
1223 Gateway Drive
Melbourne, FL 32901-2607
Phone
(321) 725-4500
Fax
(321) 727-8761
NPI assigned
Nov 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2011

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 ME79178 FL Primary

Addresses

Primary practice location

1223 Gateway Drive
Melbourne, FL 32901-2607

Mailing address

1223 Gateway Drive
Melbourne, FL 32901-2607
Phone (321) 725-4500

Other identifiers 2

IdentifierTypeStateIssuer
060068624OtherFLRR MEDICARE
260175300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, CO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100303000984 FL Practitioner - Internal Medicine 5092888768 Reassigns benefits to 1 organization
I20240820004784 CO Practitioner - Internal Medicine 5092888768 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr Joseph D Paolucci MD PA LLCGroup PAC ID 4284995424, 10 clinicians

Practice addresses (Care Compare)

250 N Wickham Rd
Melbourne, FL 32935-8625
Phone (812) 293-0025

Hospital & facility affiliations

  • Orlando Health Sebastian River Hospital Hospital, Sebastian, FL, CCN 100217
  • Orlando Health Melbourne Hospital Hospital, Melbourne, FL, CCN 100291
  • Orlando Health Hospital, Orlando, FL, CCN 100006
  • Cleveland Clinic Indian River Hospital Hospital, Vero Beach, FL, CCN 100105

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Hospitalist Services, PLLC Current Accepting new patients
Colorado Hospitalist Services, PLLC CurrentSince Jul 10, 2024 Accepting new patients
Dr Joseph D Paolucci MD PA LLC CurrentSince Aug 1, 2022 Accepting new patients

Locations

501 E Hampden Ave
Englewood, CO 80113
Phone (303) 788-5300

250 N Wickham Rd
Melbourne, FL 32935
Phone (321) 637-2600

Interoperability endpoints

  • Direct secure messaging: peter.marzano@hca4.eclinicaldirectplus.com

Organizations & group practices 3

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 4

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": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303257600000",
    "number": "1861473167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1223 GATEWAY DRIVE",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329012607",
            "telephone_number": "321-725-4500",
            "fax_number": "321-727-8761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1223 GATEWAY DRIVE",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329012607",
            "telephone_number": "321-725-4500",
            "fax_number": "321-727-8761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARZANO",
        "first_name": "PETER",
        "middle_name": "M",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-14",
        "last_updated": "2011-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME79178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "060068624",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "260175300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.