Individual provider Active NPI

Mark Charles Friedman, M.D.

  • Gastroenterology Physician
  • Harrisburg, PA
National Provider Identifier
1033197587
Registry record updated Feb 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD020602E Issued in PA
Practice address
4760 Union Deposit Rd
Suite100
Harrisburg, PA 17111-3744
Phone
(717) 545-9811
Fax
(717) 545-1873
NPI assigned
Jan 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MD020602E PA Primary

Addresses

Primary practice location

4760 Union Deposit Rd
Suite100
Harrisburg, PA 17111-3744

Mailing address

4760 Union Deposit Rd
Suite 100
Harrisburg, PA 17111-3744
Phone (717) 545-9811

Other identifiers 1

IdentifierTypeStateIssuer
0007414400002MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20050629000744 PA Practitioner - Gastroenterology 9830135987 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD020602EPAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Harrisburg Gastroenterology, LTD. Gastroenterology CurrentSince Jul 14, 2001 Accepting new patients

Locations

4760 Union Deposit Rd
Harrisburg, PA 17111
Phone (717) 545-8525

4760 Union Deposit Rd
Ste 100
Harrisburg, PA 17111
Phone (717) 545-9811

Interoperability endpoints

  • Direct secure messaging: mark.friedman@hg.eclinicaldirectplus.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1136419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360540800000",
    "number": "1033197587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4760 UNION DEPOSIT RD",
            "address_2": "SUITE 100",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171113744",
            "telephone_number": "717-545-9811",
            "fax_number": "717-545-1873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4760 UNION DEPOSIT RD",
            "address_2": "SUITE100",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171113744",
            "telephone_number": "717-545-9811",
            "fax_number": "717-545-1873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDMAN",
        "first_name": "MARK",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-05",
        "last_updated": "2013-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PA",
            "license": "MD020602E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0007414400002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

Verify at the official NPI Registry.