NPIMap

Individual provider Active NPI

Mark Allen Fisher, M.D.

  • Obstetrics & Gynecology Physician
  • Farmington, NM
National Provider Identifier
1003852716
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD2007-0662 Issued in NM
Practice address
634 W Pinon St
Farmington, NM 87401-5915
Phone
(505) 325-4898
NPI assigned
Jun 21, 2006
Last updated
Nov 14, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MA68626 NJ
Obstetrics & Gynecology Physician 207V00000X MD2007-0662 NM Primary

Addresses

Primary practice location

634 W Pinon St
Farmington, NM 87401-5915

Mailing address

PO Box 844088
Dallas, TX 75284-4088
Phone (505) 609-2258

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221103003103 NM Practitioner - Obstetrics/Gynecology 4587638358 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Rutgers New Jersey Medical School, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

634 W Pinon St
SJHP OB and GYN 634
Farmington, NM 87401-5915
Phone (505) 325-4898

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.97 of 100Reported as group
Quality
79.73
Promoting interoperability
100
Improvement activities
40
Cost
78.87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
San Juan Regional Medical Center Inc Obstetrics & Gynecology CurrentSince Oct 21, 2022 Accepting new patients
San Juan Regional Medical Center Inc Current Accepting new patients
San Juan Regional Medical Center Inc CurrentSince Oct 21, 2022 Accepting new patients
San Juan Regional Medical Center Inc Past Accepting new patients
San Juan Regional Medical Center, Inc. Past Accepting new patients
Practice Associates,Inc Obstetrics & Gynecology Past Accepting new patients

Locations

120 Llano St
Aztec, NM 87410
Phone (505) 334-3404

4820 E Main St
Ste 2
Farmington, NM 87402
Phone (505) 609-6610

610 W Pinon St
Farmington, NM 87401
Phone (505) 325-1123

634 W Pinon St
Farmington, NM 87401
Phone (505) 325-4898

634 W Pinon St
#634
Farmington, NM 87401
Phone (505) 325-4898

Interoperability endpoints

  • Direct secure messaging: mark.fisher.1@12045.direct.athenahealth.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1003852716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844088",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844088",
            "telephone_number": "505-609-2258",
            "fax_number": "505-609-2259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "634 W PINON ST",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874015915",
            "telephone_number": "505-325-4898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "MARK",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NJ",
            "license": "MA68626",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NM",
            "license": "MD2007-0662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, NM

Sources for this page

Verify at the official NPI Registry.