MARK RICHARD WEATHERLY M.D.
NPI 1881703650
Pediatrics - Pediatric Pulmonology in Orlando, FL

Q: What is Mark Weatherly's NPI number?

The NPI number for Mark Weatherly is 1881703650. It was assigned to this individual provider in the NPPES registry on August 29, 2006.

Q: What is Mark Weatherly's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Pulmonology, with taxonomy code 2080P0214X.

Q: When was this NPI record last updated?

The NPPES record for Mark Weatherly was last updated on November 10, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.

Active since August 29, 2006PECOS EnrolledAccepts Medicare Assignment

60 W GORE STREET, ORLANDO, FL 32806(407) 351-5384(407) 445-0321 Get Directions Write a Review

NPPES record last updated: November 10, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Mark Richard Weatherly M.d. NPPES

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

MARK RICHARD WEATHERLY M.D. (NPI 1881703650) is an individual pediatric pulmonology provider in Orlando, Florida, licensed in Florida (ME62498) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS and is a graduate of Michigan State University College Of Human Medicine (1986).

NPPES Registry Identity

NPI1881703650

Entity TypeIndividualMale

Primary Taxonomy2080P0214X

Provider Legal NameMARK RICHARD WEATHERLYCredential: M.D.

Location Address60 W GORE STREETOrlando, FL 32806-1101

Mailing Address60 W Gore StreetOrlando, FL 32806-1101 · (407) 351-5384 · Fax (407) 445-0321

Phone(407) 351-5384

Fax(407) 445-0321

Sole ProprietorNo

Medical School CMSMichigan State University College Of Human MedicineGraduated 1986

Enumeration DateAugust 29, 2006

Last NPPES UpdateNovember 10, 2016

✔ NPI 1881703650 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Pediatric PulmonologyAllopathic & Osteopathic Physicians

Taxonomy Code2080P0214X

License✔ Licensed in FL · ME62498

Definition

A pediatrician dedicated to the prevention and treatment of all respiratory diseases affecting infants, children and young adults. This specialist is knowledgeable about the growth and development of the lung, assessment of respiratory function in infants and children, and experienced in a variety of invasive and noninvasive diagnostic techniques.

60 W GORE STREET, Orlando, FL 32806

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Other Identifiers 5

Medicaid1419354LA

Medicare PIN17789TFL

Medicaid7616163NC

Medicaid370776800FL

OtherME62498FL · Medical License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AmeriHealth Caritas Next, AvMed, Florida Blue (BlueCross BlueShield FL) and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mark Richard Weatherly 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 ID8426110461

PECOS Enrollment IDI20081229000333

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.

Other Providers at the Same Location NPPES 5

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

CARLOS E SABOGAL

Pediatrics (Pediatric Pulmonology)