Marc Edwin McCollaum, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9102277 Issued in FL

Practice address

11725 Collier Blvd H
Naples, FL 34116-6524

Phone

(239) 349-2500

Fax

(239) 349-2501

NPI assigned

May 16, 2006

Last updated

Dec 13, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

University of Nebraska College of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Estates Medical Center IncGroup PAC ID 6800038829, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Physicians Regional Medical Center - Pine Ridge Hospital, Naples, FL, CCN 100286

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/AAHDBD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Estates Medical Center, Inc

  • General Practice Physician
  • Naples, FL
  • NPI 1396182317
  Medicare reassignment Care Compare group Authorized official
• Gulf Coast Mobile Medicine, LLC

  • Medical Physician Assistant
  • Naples, FL
  • NPI 1417237785
  NPD Authorized official
• Millennium Physician Group LLC

  • Family Medicine Physician
  • Fort Myers, FL
  • NPI 1811122880
  NPD
• Karelia Ruiz MD PA

  • Primary Care Clinic/Center
  • Hialeah, FL
  • NPI 1558511345
  NPD (past)
• Naples Emergency Physicians LLC

  • Nurse Practitioner
  • Naples, FL
  • NPI 1598748006

  Physician Assistant

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Naples Hma LLC

  dba Physicians Regiona Medical Center-Collier

  • General Acute Care Hospital
  • Naples, FL
  • NPI 1215003348
  Care Compare affiliation
• Naples Hma LLC

  dba Physicians Regional Medical Center-Pine Ridge

  • General Acute Care Hospital
  • Naples, FL
  • NPI 1316992134
  Care Compare affiliation

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481587200000",
    "number": "1871545046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11725 COLLIER BLVD H",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341166524",
            "telephone_number": "239-349-2500",
            "fax_number": "239-349-2501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11725 COLLIER BLVD H",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341166524",
            "telephone_number": "239-349-2500",
            "fax_number": "239-349-2501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOLLAUM",
        "first_name": "MARC",
        "middle_name": "EDWIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2016-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9102277",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y08XG",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan M McCarthy, APRN
• Mary Ann McCarty, R.N.
• Christopher McCash, D.M.D
• Virgil Mark McClintic Jr., O.D.
• Nirmala McClure, PHARM.D
• Lauren Brooke McConnell
• Amanda Renee McCorkle, FNP-BC
• Jasmine McCormick, RN
• Lucas McCormick, DC
• Teresa H McCormick, CRNA

• Physician Assistant in Naples, FL
• Providers in Naples, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2016; 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.

Verify at the official NPI Registry.