Mr Marc Edward Marchioli, PA is a medicare enrolled "Physician Assistant" physician in Lake Wales, Florida. His current practice location is
410 S 11th St, Lake Wales, Florida. You can reach out to his office (for appointments etc.) via phone at
(407) 303-7283.
Mr Marc Edward Marchioli is licensed to practice in Florida (license number PA9106961) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1639450778.
Physician's Profile
| Full Name | Mr Marc Edward Marchioli |
|---|
| Gender | Male |
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| Speciality | Physician Assistant |
|---|
| Location | 410 S 11th St, Lake Wales, Florida |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1639450778
- Provider Enumeration Date: 09/02/2011
- Last Update Date: 08/18/2025
Medicare PECOS Information:
- PECOS PAC ID: 6608049093
- Enrollment ID: I20111228000386
Medical Identifiers
Medical identifiers for Mr Marc Edward Marchioli such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1639450778 | NPI | - | NPPES |
| 965 | Other | GA | GA STATE LICENSE |
| 7100961270 | Medicaid | KY | |
| MA055058 | Other | PA | PA STATE LICENSE |
| PA2023-0208 | Other | NM | NM LICENSE |
| PA3370 | Other | KY | STATE LICENSE |
| PA9106961 | Other | FL | FL STATE LICENSE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207RC0200X | Internal Medicine - Critical Care Medicine | 965 (Georgia) | Secondary |
| 208M00000X | Hospitalist | 965 (Georgia) | Secondary |
| 363A00000X | Physician Assistant | PA-TF-0188 (Massachusetts) | Secondary |
| 363A00000X | Physician Assistant | PA3370 (Kentucky) | Secondary |
| 363A00000X | Physician Assistant | 5601010961 (Michigan) | Secondary |
| 363A00000X | Physician Assistant | 0110010754 (Virginia) | Secondary |
| 363A00000X | Physician Assistant | 085009455 (Illinois) | Secondary |
| 363AM0700X | Physician Assistant - Medical | 023516 (New York) | Secondary |
| 363AM0700X | Physician Assistant - Medical | MA055058 (Pennsylvania) | Secondary |
| 363AM0700X | Physician Assistant - Medical | PA2023-0208 (New Mexico) | Secondary |
| 363A00000X | Physician Assistant | PA9106961 (Florida) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Marc Edward Marchioli is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Marc Edward Marchioli, PA
410 S 11th St,
Lake Wales, FL 33853-4203
Ph: (407) 303-7283 | Mr Marc Edward Marchioli, PA
410 S 11th St,
Lake Wales, FL 33853-4203
Ph: (407) 303-7283 |
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