Active NPI
Mark R Palazzolo, DO
- Obstetrics & Gynecology Physician
- Kissimmee, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- OS10224
- Practice address
- 1160 Cypress Glen Cir
Kissimmee, FL 34741-7560 - Phone
- (407) 518-1074
- NPI assigned
- Jul 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | OS10224 | FL | Primary |
Addresses
Primary practice location
1160 Cypress Glen Cir
Kissimmee, FL 34741-7560
Mailing address
502 Golfpark Dr
Celebration, FL 34747-4626
Phone (586) 801-8980
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200000002505 | Other | MI | PHP |
| 281269000 | Medicaid | FL | |
| AS941Y | Other | FL | MEDICARE |
| P00014737 | Other | MI | RAILROAD MEDICARE |
| 4505156 | Medicaid | MI |
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: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Obstetrics/Gynecology
- Education
- Michigan State University College of Osteopathic Medicine, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1160 Cypress Glen Cir
Kissimmee, FL 34741-7560
Phone (407) 518-1074
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.76 of 100
- Quality
- 84.84
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 77.7
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS10224 | FL | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| OBGYN Hospitalist Services of Central Florida, LLC | Obstetrics & Gynecology | Current | Accepting new patients |
| Florida Woman Care, LLC | Obstetrics & Gynecology | Current | Accepting new patients |
| Osceola Regional Hospitalists LLC | Obstetrics & Gynecology | Past | Accepting new patients |
Locations
2815 S Seacrest Blvd
Ste 112
Boynton Beach, FL 33435
Phone (561) 368-0233
1160 Cypress Glen Cir
Kissimmee, FL 34741
Phone (407) 518-1993
13 Neptune Rd
Kissimmee, FL 34744
3722 Avalon Park East Blvd
Orlando, FL 32828
Phone (407) 453-2072
3000 Hunters Creek Blvd
Orlando, FL 32837
Phone (407) 337-8814
1018 Cypress Pkwy
Poinciana, FL 34759
Phone (321) 402-0560
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Interoperability endpoints
- mark.palazzolo.1@2183.direct.athenahealth.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.
-
- Obstetrics & Gynecology Physician
- Tampa, FL
- NPI 1386823243
-
- Obstetrics & Gynecology Physician
- Kissimmee, FL
- NPI 1386241677
-
- Obstetrics & Gynecology Physician
- Kissimmee, FL
- NPI 1215106521
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405468800000",
"number": "1972520559",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "502 GOLFPARK DR",
"city": "CELEBRATION",
"state": "FL",
"postal_code": "347474626",
"telephone_number": "586-801-8980"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1160 CYPRESS GLEN CIR",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347417560",
"telephone_number": "407-518-1074"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALAZZOLO",
"first_name": "MARK",
"middle_name": "R",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-17",
"last_updated": "2014-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "FL",
"license": "OS10224",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHP",
"identifier": "200000002505",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "281269000",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "AS941Y",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00014737",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4505156",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Kissimmee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2014; 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.