Mark Prebonich, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME162650 Issued in FL

Practice address

2343 Aaron St
Port Charlotte, FL 33952-5305

Phone

(941) 629-2900

Fax

(855) 808-2036

NPI assigned

Oct 6, 2006

Last updated

Feb 27, 2024By 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 2

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

University of Minnesota Medical School, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians

Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Millennium Home Care LLC Home health agency, Port Charlotte, FL, CCN 109401
• HCA Florida Healthcare at Home Home health agency, PT Charlotte, FL, CCN 108013
• Amedisys Home Health Home health agency, Port Charlotte, FL, CCN 108270
• HCA Florida Fawcett Hospital Hospital, Port Charlotte, FL, CCN 100236

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: mark.prebonich.1@4290.direct.athenahealth.com

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.

• Millennium Physician Group LLC

  • Family Medicine Physician
  • Fort Myers, FL
  • NPI 1811122880

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Millennium Physician Group LLC

  • Family Medicine Physician
  • Brooksville, FL
  • NPI 1073131702
  NPD

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

• Fawcett Memorial Hospital, Inc.

  dba HCA Florida Fawcett Hospital

  • General Acute Care Hospital
  • Port Charlotte, FL
  • NPI 1417901406
  Care Compare affiliation
• Infinity Home Care of Port Charlotte, LLC

  dba Amedisys Home Health

  • Home Health Agency
  • Port Charlotte, FL
  • NPI 1043392038
  Care Compare affiliation
• Millennium Home Care LLC

  • Home Health Agency
  • Port Charlotte, FL
  • NPI 1700058583
  Care Compare affiliation
• Nurse on Call, LLC

  dba HCA Florida Healthcare at Home

  • Home Health Agency
  • PT Charlotte, FL
  • NPI 1891747952
  Care Compare affiliation

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1912094442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE # 2ND",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "877-856-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2343 AARON ST",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339525305",
            "telephone_number": "941-629-2900",
            "fax_number": "855-808-2036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREBONICH",
        "first_name": "MARK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "40109",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME162650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara Poteat-Gill
• Phil Potempa, DDS
• Chris Eric Potter, FNP-BC
• Kimberly Pouk
• Neil Garrett Powell Jr., MD
• Precision Medical Imaging
• Premier Dental and Orthodontics of Port Charlotte
• Premier Health Services PA
• Serge A Prescott, DDS
• Kimberly Presnell, APRN

• Internal Medicine Physician in Port Charlotte, FL
• Providers in Port Charlotte, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2024; 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.