Mark A Rackish, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

MD045565L Issued in PA

Practice address

1705 Warren Ave
Suite 101-103
Williamsport, PA 17701-2647

Phone

(570) 321-2020

Fax

(570) 320-7576

NPI assigned

Mar 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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

• West Branch Orthopedics and Sports Medicine

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Williamsport, PA
  • NPI 1528039591
  NPD (past)

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

{
    "created_epoch": "1143244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471478400000",
    "number": "1003876715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 GRAMPIAN BLVD",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 WARREN AVE",
            "address_2": "SUITE 101-103",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177012647",
            "telephone_number": "570-321-2020",
            "fax_number": "570-320-7576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RACKISH",
        "first_name": "MARK",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-25",
        "last_updated": "2016-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "PA",
            "license": "MD045565L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001259522",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Providence Pediatrics, PC
• Kellie Forziat Pytel, PHD, LPC, NCC
• Nicholas Pytel
• Allyson Quigley, PA-C
• David Quintana, MD
• Matthew Rader, MSW
• Radiance Wellness Group LLC
• David Neil Raemore, DMD
• Lauren Raemore, DMD
• Fahmi Rahman

• Orthopaedic Surgery Physician in Williamsport, PA
• Providers in Williamsport, PA by specialty
• Orthopaedic Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.