Individual provider Active NPI

Mark A. Dreyer, DPM, FACAFAS

  • Foot & Ankle Surgery Podiatrist
  • Bradenton, FL
National Provider Identifier
1952735219
Registry record updated Mar 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO4081 Issued in FL
Practice address
11505 Rangeland Pkwy
Bradenton, FL 34211-4041
Phone
(941) 362-8662
Fax
(941) 362-8602
NPI assigned
Aug 22, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Military Health Care Provider 171000000X 00347 RI
Foot & Ankle Surgery Podiatrist 213ES0103X 00347 RI
Foot & Ankle Surgery Podiatrist 213ES0103X PO4081 FL Primary

Addresses

Primary practice location

11505 Rangeland Pkwy
Bradenton, FL 34211-4041

Mailing address

11505 Rangeland Pkwy
Bradenton, FL 34211-4041
Phone (941) 362-8662

Other identifiers 2

IdentifierTypeStateIssuer
103607100MedicaidFL
253654405MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Mark.Dreyer@img.directbygreenway.com Direct

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190805001466 FL Practitioner - Podiatry 8224312699 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Intercoastal Medical Group IncGroup PAC ID 6305730912, 176 clinicians
Sports and Orthopedic Rehabilitation Services IncGroup PAC ID 0840104253, shared by 4 NPIs, 314 clinicians

Practice addresses (Care Compare)

11505 Rangeland Pkwy
Bradenton, FL 34211-4041
Phone (941) 907-6016

8429 Tuttle Ave
Sarasota, FL 34243-2868
Phone (941) 413-1550

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Melanoma (skin cancer) excision1-10
Removal of tissue261
Removal of skin lesions114
Removal of nail tissue784
Removal or shaving of skin growth548
Skin biopsy39

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00347RIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Intercoastal Medical Group Inc Foot & Ankle Surgery CurrentSince Sep 1, 2020 Accepting new patients

Locations

11505 Rangeland Pkwy
Bradenton, FL 34211
Phone (941) 907-6016

11505 Rangeland Pkwy
Fl 1
Bradenton, FL 34211

943 S Beneva Rd
Ste 306
Sarasota, FL 34232
Phone (941) 362-8644

921 S Beneva Rd
Sarasota, FL 34232
Phone (941) 365-7390

Interoperability endpoints

  • Direct secure messaging: mark.dreyer@img.directbygreenway.com

Organizations & group practices 1

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 5

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": "1377129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772755200000",
    "number": "1952735219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11505 RANGELAND PKWY",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342114041",
            "telephone_number": "941-362-8662",
            "fax_number": "941-362-8602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11505 RANGELAND PKWY",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342114041",
            "telephone_number": "941-362-8662",
            "fax_number": "941-362-8602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DREYER",
        "first_name": "MARK",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "DPM, FACAFAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-22",
        "last_updated": "2026-03-06",
        "certification_date": "2026-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "RI",
            "license": "00347",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "RI",
            "license": "00347",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO4081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103607100",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "253654405",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Mark.Dreyer@img.directbygreenway.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "11505 Rangeland Pkwy",
            "city": "Bradenton",
            "state": "FL",
            "country_code": "US",
            "postal_code": "342114041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.