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Deactivated NPI 1376862904 Deactivated / Inactive NPI Female Practitioner

Susan Beth Marcus , OROFACIAL MYOLOGIST

Specialist • Tierra Verde, FL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Susan Marcus has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date May 21, 2010
NPI Deactivation Date July 17, 2025
Total Practice Duration ~15 Years of Practice (2010 – 2025)

Professional Overview & Biography Verified Profile Summary

Susan Marcus, OROFACIAL MYOLOGIST was a registered Specialist practicing in Tierra Verde, FL. Throughout an active medical career spanning 15 years, Susan Marcus provided care at the practice location at 719 PINELLAS BAYWAY S until profile deactivation on 2025-07-17.

Practice Location & Contact Primary Location

Practice Address

719 Pinellas Bayway S
Unit 201

Tierra Verde, FL 33715

Telephone 7279546733
Fax 3094056496

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Tierra Verde, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 37.8 Yrs
Regional Practice Density
1 Specialists

Practicing in Tierra Verde, FL (3036 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated July 17, 2025

Record deactivated on July 17, 2025

NPI Profile Active May 21, 2010

NPI status registered as active in NPPES database

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Updated Practice Location May 21, 2010

Registered at 719 PINELLAS BAYWAY S, UNIT 201, TIERRA VERDE, FL 33715 (Tel: 7279546733)

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Updated Business Mailing Address May 21, 2010

Registered at 4905 34TH STREET SOUTH, #154, ST PETERSBURG, FL 33711 (Tel: 7279546733)

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Provider Name / Credentials Updated May 21, 2010

Recorded as SUSAN MARCUS, OROFACIAL MYOLOGIST

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Medical Taxonomy / Specialty Registered (Primary Specialty) May 21, 2010

Specialist

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Initial NPI Registration & Enumeration May 21, 2010

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1376862904
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 21, 2010
Last Update: May 21, 2010
Deactivation Date: July 17, 2025

Mailing Address

4905 34th Street South, #154

St Petersburg, FL 33711

Phone: 7279546733

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

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