Individual provider Active NPI

Mark R Palazzolo, DO

  • Obstetrics & Gynecology Physician
  • Kissimmee, FL
National Provider Identifier
1972520559
Registry record updated Jul 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
OS10224 Issued in FL
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

Updated by the provider on Jul 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
200000002505OtherMIPHP
281269000MedicaidFL
AS941YOtherFLMEDICARE
P00014737OtherMIRAILROAD MEDICARE
4505156MedicaidMI

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081106000481 FL Practitioner - Obstetrics/Gynecology 9032278999 Reassigns benefits to 1 organization

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
Florida Woman Care LLCGroup PAC ID 5395807218, 607 clinicians

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 100Reported as group
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

LicenseStateTypeSpecialty
OS10224FLMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
OBGYN Hospitalist Services of Central Florida, LLC Obstetrics & Gynecology Current Accepting new patients
Florida Woman Care, LLC Obstetrics & Gynecology CurrentSince Oct 24, 2017 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.