Mara S. Riegsecker, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9103270 Issued in FL

Practice address

5100 N 12TH Ave Ste 101
Pensacola, FL 32504-8919

Phone

(850) 208-6130

Fax

(850) 208-6136

NPI assigned

Jan 13, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Brevard Emergency Services

  • Internal Medicine Physician
  • Melbourne, FL
  • NPI 1104870393
  NPD (past)

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779840000000",
    "number": "1932188398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95590",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840950590",
            "telephone_number": "801-784-0954",
            "fax_number": "801-352-7976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 N 12TH AVE STE 101",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048919",
            "telephone_number": "850-208-6130",
            "fax_number": "850-208-6136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIEGSECKER",
        "first_name": "MARA",
        "middle_name": "S.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-13",
        "last_updated": "2026-05-27",
        "certification_date": "2026-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "1314",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9103270",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9103270",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marilyn E Ricketts, ARNP CNM
• Scott Elliot Rickoff, DPM
• Susan Campbell Riddick, R.D., L.D.
• Al M Ridlehoover, DDS
• Katie Riegle, PA-C
• Bonnie Vail Rieland, FNP-C
• Megan Jane Rieman, O.D.
• Orestes L Riera, DMD
• Michael Van Riesberg, M.D.
• Ryan Rietz, DPT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.