Individual provider Active NPI

Mark Cockerill, MD

  • Vascular & Interventional Radiology Physician
  • Norfolk, VA
National Provider Identifier
1033188537
Registry record updated Feb 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
0101055902 Issued in VA
Practice address
150 Kingsley LN
Norfolk, VA 23505-4602
Phone
(757) 889-5422
Fax
(757) 889-5450
NPI assigned
Mar 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 0101055902 VA
Vascular & Interventional Radiology Physician 2085R0204X 0101055902 VA Primary

Addresses

Primary practice location

150 Kingsley LN
Norfolk, VA 23505-4602

Mailing address

110 Kingsley LN Ste 305
Norfolk, VA 23505-4617
Phone (757) 889-5422

Other identifiers 1

IdentifierTypeStateIssuer
7240520MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20060808000426 VA Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 3375546583 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional RadiologyAlso: Diagnostic Radiology
Education
University of Maryland School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hampton Roads Radiology Associates, PCGroup PAC ID 4880688506, 39 clinicians

Practice addresses (Care Compare)

582 Lynnhaven Pkwy
Suite 301
Virginia Beach, VA 23452-7386
Phone (757) 916-9630

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.4 of 100Reported as group
Quality
100
Improvement activities
40
Cost
77.98

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101055902VAMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group Diagnostic Radiology CurrentSince Oct 1, 2007 Accepting new patients
Hampton Roads Radiology Associates, PC Diagnostic Radiology CurrentSince Jul 1, 1997 Accepting new patients
Kingsley Lane Anatomic Pathology Current Accepting new patients

Locations

150 Kingsley Ln
Norfolk, VA 23505
Phone (757) 464-6944

582 Lynnhaven Pkwy
Ste 301
Virginia Beach, VA 23452
Phone (757) 916-9631

Organizations & group practices 3

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 3

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": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581379200000",
    "number": "1033188537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 KINGSLEY LN STE 305",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235054617",
            "telephone_number": "757-889-5422",
            "fax_number": "757-889-5450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 KINGSLEY LN",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235054602",
            "telephone_number": "757-889-5422",
            "fax_number": "757-889-5450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COCKERILL",
        "first_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0101055902",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "VA",
            "license": "0101055902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7240520",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.