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MARCUS DECARVALHO M.D.
NPI 1427213727
Psychiatry & Neurology - Psychiatry in Jacksonville, FL

Active since July 25, 2008PECOS EnrolledAccepts Medicare Assignment
76.75/100
CMS Quality Rating
6817 SOUTHPOINT PKWY STE 1301, JACKSONVILLE, FL 32216(904) 527-8777(904) 379-5744 Get Directions Write a Review

NPPES record last updated: November 15, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 15, 2023, Sep 23, 2019, Aug 28, 2019 (3 updates tracked since 2019).

About Marcus Decarvalho M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARCUS DECARVALHO M.D. (NPI 1427213727) is an individual psychiatry provider in Jacksonville, Florida, licensed in Florida (ME 108768) and active in the NPI registry since July 2008. He is enrolled in Medicare PECOS and is a graduate of Other (2008).

NPPES Registry Identity

NPI1427213727
Entity TypeIndividualMale
Primary Taxonomy2084P0800X
Provider Legal NameMARCUS DECARVALHOCredential: M.D.
Location Address6817 SOUTHPOINT PKWY STE 1301Jacksonville, FL 32216-6297
Mailing Address6817 Southpoint Pkwy Ste 1301Jacksonville, FL 32216-6297 · (904) 527-8777 · Fax (904) 379-5744
Phone(904) 527-8777
Fax(904) 379-5744
Sole ProprietorNo
Medical School CMSOtherGraduated 2008
Enumeration DateJuly 25, 2008
Last NPPES UpdateNovember 15, 20233 updates tracked since enumeration
NPPES CertifiedNovember 15, 2023
✔ NPI 1427213727 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
License✔ Licensed in FL · ME 108768
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
6817 SOUTHPOINT PKWY STE 1301, Jacksonville, FL 32216
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Marcus Decarvalho M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6002088457
PECOS Enrollment IDI20120816000122
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Marcus Decarvalho reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Center For A Healthy Mind And Wellbeing LLC
Same address
Psychiatry
6817 SOUTHPOINT PKWY STE 1301
Jacksonville, FL 32216
  • Reassigned Medicare billing, Florida enrollment
  • 2 clinicians in this Medicare group
NPI 1710243571 (904) 527-8777
Wekiva Springs Center LLC
0.5 mi
Psychiatric Hospital
3947 SALISBURY RD
Jacksonville, FL 32216
  • Reassigned Medicare billing, Florida enrollment
  • 29 clinicians in this Medicare group
NPI 1942471065 (904) 296-3533

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
589 services99 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
306 services103 patients
Psychotherapy with evaluation and management visit, 30 minutes 90833
Psychotherapy with evaluation and management is a 30-minute session where a mental health professional talks with you about your concerns and feelings. They assess your mental health, provide support, and manage your treatment plan to help improve your well-being.
231 services97 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
181 services93 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
111 services63 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
92 services83 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32216 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$171.84 typical visit price
range $56.00 – $171.84
Typical copayment $42.96 (range $14.00 – $42.96)
Most-billed visit code 99205
Established Patient
$70.04 typical visit price
range $17.57 – $139.16
Typical copayment $17.51 (range $4.39 – $34.79)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

76.75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality93.68
Improvement Activities40
Cost14.27

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CENTER FOR A HEALTHY MIND AND WELLBEING LLC
Psychiatry & Neurology (Psychiatry)
6817 SOUTHPOINT PKWY STE 1301
JACKSONVILLE, FL 32216
Duval County (904) 527-8777

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Marcus Decarvalho's NPI number?

The NPI number for Marcus Decarvalho is 1427213727. It was assigned to this individual provider in the NPPES registry on July 25, 2008.

Where is Marcus Decarvalho located?

Marcus Decarvalho practices at 6817 Southpoint Pkwy Ste 1301, Jacksonville, FL 32216. The listed phone number is (904) 527-8777.

What is Marcus Decarvalho's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Marcus Decarvalho enrolled in Medicare?

Yes. Marcus Decarvalho is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Marcus Decarvalho's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Marcus Decarvalho reassigns Medicare benefits to 2 organizations: Center For A Healthy Mind And Wellbeing LLC (Jacksonville, FL) and Wekiva Springs Center LLC (Jacksonville, FL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Marcus Decarvalho's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Marcus Decarvalho accept?

Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Ambetter of Alabama, Cigna HealthCare of Florida, Inc. and Cigna Healthcare and 5 other insurers list Marcus Decarvalho as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Marcus Decarvalho was last updated on November 15, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.