Mark Allen Fisher, M.D.
Individual provider Active NPI Obstetrics & Gynecology Physician · Farmington, NM
NPI 1003852716 · NPPES record last updated Nov 14, 2024
Key facts
- NPI
- 1003852716
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- MD2007-0662 (NM)
- Practice address
- 634 W Pinon St
Farmington, NM 87401-5915 - Phone
- (505) 325-4898
- NPI assigned
- Jun 21, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 8
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Obstetrics/Gynecology
- Education
- Rutgers New Jersey Medical School, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- San Juan Regional Medical Center, Inc.
Practice addresses (Care Compare)
634 W Pinon St
SJHP OB and GYN 634
Farmington, NM 87401-5915
Phone (505) 325-4898
Hospital & facility affiliations
- San Juan Regional Medical Center Inc
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.97 of 100
- Quality
- 79.73
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 78.87
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221103003103 | NM | Practitioner - Obstetrics/Gynecology | 4587638358 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA68626 | NJ | MD | Obstetrics & Gynecology Physician |
| MD2007-0662 | NM | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| San Juan Regional Medical Center Inc | Current |
Accepting new patients | |
| San Juan Regional Medical Center Inc | Current | Accepting new patients | |
| San Juan Regional Medical Center Inc | Obstetrics & Gynecology | Current |
Accepting new patients |
| San Juan Regional Medical Center Inc | Past | Accepting new patients | |
| Practice Associates,Inc | Obstetrics & Gynecology | Past | Accepting new patients |
| San Juan Regional Medical Center, Inc. | Past | Accepting new patients |
Locations
120 Llano St
Aztec, NM 87410
Phone (505) 334-3404
634 W Pinon St
#634
Farmington, NM 87401
Phone (505) 325-4898
610 W Pinon St
Farmington, NM 87401
Phone (505) 325-1123
4820 E Main St
Ste 2
Farmington, NM 87402
Phone (505) 609-6610
634 W Pinon St
Farmington, NM 87401
Phone (505) 325-4898
Interoperability endpoints
- mark.fisher.1@12045.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | MA68626 | NJ | |
| Obstetrics & Gynecology Physician | 207V00000X | MD2007-0662 | NM | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12986062 | Medicaid | NM |
Other providers in Farmington, NM
- C. Norman Finch Jr.
- Find What Works LLC
- Tinamarie Findlay
- Patricia Fine
- Makayla Fischer
- Miranda Brooke Fiske
- Rosemary Fleming
- Marc Flitter
- Brittany Florence
- Candace Esther Flores
All providers in Farmington, NM · Obstetrics & Gynecology Physician in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 14, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.