MARK VINICKY – Internal Medicine Physician, NPI 1114592961

MARK VINICKY is a healthcare provider. based in Hollywood, Florida. specializing in INTERNAL MEDICINE. They hold a License No. OS21355 (FL). The NPI Number for MARK VINICKY is 1114592961

Main info

Male
Sole Proprietor
5 Years Of Experience
Accepts Medicare Assignment
Name
MARK VINICKY
NPI
1114592961
Phone
(708) 674-8376
Address
5182 EUCALYPTUS DR UNIT 6
Enumeration Date
24 May 2021
Last Update Date
14 November 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9543443000
Graduation Year
2021 (5 years ago)
PAC ID
0941676472
Group Practice PAC ID
7719268333
Professional Enrollment ID
I20241127003404
Address ID
FL330654108CO3000XDRXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness75
Years active:5State licenses:1Digital endpointsOther names

12,368 INTERNAL MEDICINE in FL

Provider Addresses for MARK VINICKY

  • 5182 EUCALYPTUS DR UNIT 6

    HOLLYWOOD, FL 330217180

    Phone: (708) 674-8376

    Type: Mailing

  • 3000 CORAL HILLS DR

    CORAL SPRINGS, FL 330654108

    Phone: (954) 344-3000

    Type: Mailing

  • 10101 FOREST HILL BLVD

    WELLINGTON, FL 334146103

    Phone: (561) 798-8504

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-11-27

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241127003404IInternal MedicineFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33021)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7719268333View full group profile
NameSpecialtyState
Internal MedicineFL
Internal MedicineLA
-FL
Internal MedicineTX
-FL
Internal MedicineAR
Internal Medicine, HospitalistFL
Internal MedicineFL
Internal MedicineFL
Internal MedicineIL

Reviews

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Frequently asked questions

Can I use this page to confirm MARK VINICKY's NPI?
Yes. MARK VINICKY is listed with NPI 1114592961 in the public NPI dataset.
Does the file indicate MARK VINICKY is practicing under active NPI?
Directory data currently reports MARK VINICKY as active.
What is MARK VINICKY's primary classification?
Internal Medicine Physician is the headline specialty for MARK VINICKY here. Clinical services aligned with this taxonomy classification.
Where should I expect MARK VINICKY on a map?
Expect Hollywood, Florida as a primary anchor for MARK VINICKY unless the record lists multiple sites.
Why does MARK VINICKY have multiple addresses?
3 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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