Mark K. Komar, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35044920 Issued in OH

Practice address

9500 Mentor Ave
Suite 100
Mentor, OH 44060-8713

Phone

(440) 352-4880

Fax

(440) 352-3629

NPI assigned

Mar 1, 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

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Lake Hospital System Inc

  • Family Medicine Physician
  • Middlefield, OH
  • NPI 1952339996
  Medicare reassignment NPD
• Lake Hospital System Inc.

  • Clinic/Center
  • Middlefield, OH
  • NPI 1669778676
  NPD
• Lake Hospital System, Inc

  • Urgent Care Clinic/Center
  • Chardon, OH
  • NPI 1689634966

  Family Medicine

  NPD

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421107200000",
    "number": "1003883711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 MENTOR AVE",
            "address_2": "SUITE 100",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440608713",
            "telephone_number": "440-352-4880",
            "fax_number": "440-352-3629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 MENTOR AVE",
            "address_2": "SUITE 100",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440608713",
            "telephone_number": "440-352-4880",
            "fax_number": "440-352-3629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMAR",
        "first_name": "MARK",
        "middle_name": "K.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2015-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35044920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0468524",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas Koenig
• Christine Marie Kofol
• Sandra Kolansinski, P.T.A.
• Matthew Koller
• Frank Gus Komar, DDS
• Kimberly Kornokovich, RPH
• Lisa Ann Kostansek, PCC-S, LCDC III
• Marianne. P. Kostiha, RN
• Erin Kay Kotkowski, PSYD
• Haitham J Kousa, M.D.

• Family Medicine Physician in Mentor, OH
• Providers in Mentor, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.