Individual provider Active NPI

Mark J Vellek, M.D.

  • Hematology & Oncology Physician
  • Las Vegas, NV
National Provider Identifier
1063409688
Registry record updated Dec 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
20944 Issued in NV
Practice address
3131 La Canada St Ste 140
Las Vegas, NV 89169-2579
Phone
(702) 933-9400
Fax
(702) 933-9444
NPI assigned
Sep 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X C2194 KY
Hematology & Oncology Physician 207RH0003X 20944 NV Primary
Hematology & Oncology Physician 207RH0003X R5H89 MO

Addresses

Primary practice location

3131 La Canada St Ste 140
Las Vegas, NV 89169-2579

Mailing address

PO Box 98978
Las Vegas, NV 89193-8978
Phone (702) 216-3346

Other practice location 1

1705 E Broadway
Suite 100
Columbia, MO 65201-5852
Phone (573) 874-7800

Other practice location 2

803 Poplar St
Murray, KY 42071-2432
Phone (270) 762-1597

Other identifiers 9

IdentifierTypeStateIssuer
171205OtherHEALTHLINK
106095OtherBCBS OF MO
1210OtherGHP
203284625MedicaidMO
3604003OtherUNITED HEALTHCARE
F19081OtherMERCY HEALTH PLANS
65201A002OtherTRICARE
1063409688MedicaidNV
5132415OtherAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210928001077 NV Practitioner - Hematology/Oncology 9335166776 Reassigns benefits to 1 organization
I20230213000510 OR Practitioner - Medical Oncology 9335166776 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
University of Minnesota Medical School, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

300 S 8TH St
Suite 480W
Murray, KY 42071-2403

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Murray-Calloway County Public Hospital Corporation Hematology & Oncology CurrentSince Jan 1, 2024 Accepting new patients
Intermountain Medical Holdings Nevada Inc Hematology & Oncology CurrentSince Jan 10, 2022 Accepting new patients
Murray-Calloway County Public Hospital Corporation CurrentSince Jan 1, 2024 Accepting new patients
Mid-Columbia Medical Center CurrentSince Mar 1, 2023 Accepting new patients
Mid-Columbia Medical Center Current Accepting new patients
Mid-Columbia Medical Center CurrentSince Mar 1, 2023 Accepting new patients
Intermountain Medical Holdings Nevada Inc CurrentSince Jan 10, 2022 Accepting new patients
Healthcare for the Mid-Columbia Region Current Accepting new patients
Ctca Physicians Group of Illinois, Inc Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

300 S 8th St
Ste 480W
Murray, KY 42071
Phone (270) 762-1104

803 Poplar St
Murray, KY 42071
Phone (270) 762-1155

4880 Wynn Rd
Las Vegas, NV 89103
Phone (702) 382-4554

6355 S Buffalo Dr
Fl 3
Las Vegas, NV 89113
Phone (702) 479-4881

3131 La Canada St
Ste 140
Las Vegas, NV 89169
Phone (702) 933-9400

3131 La Canada St
Las Vegas, NV 89169
Phone (702) 636-6360

1397 S Loop Rd
Pahrump, NV 89048
Phone (775) 727-5500

1805 E 19th St
The Dalles, OR 97058
Phone (541) 296-2201

1700 E 19th St
The Dalles, OR 97058
Phone (541) 296-7251

1620 E 12th St
The Dalles, OR 97058
Phone (541) 296-9151

Interoperability endpoints

  • Direct secure messaging: mark.vellek.1@9266.direct.athenahealth.com
  • Direct secure messaging: mark.vellek@mca.ikm.direct-ci.com

Organizations & group practices 10

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.

Hospital & facility affiliations 4

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": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1063409688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 98978",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891938978",
            "telephone_number": "702-216-3346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 LA CANADA ST STE 140",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891692579",
            "telephone_number": "702-933-9400",
            "fax_number": "702-933-9444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1705 E Broadway",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MO",
            "postal_code": "652015852",
            "country_code": "US",
            "telephone_number": "573-874-7800",
            "fax_number": "573-443-3627",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "803 Poplar St",
            "address_purpose": "LOCATION",
            "city": "Murray",
            "state": "KY",
            "postal_code": "420712432",
            "country_code": "US",
            "telephone_number": "270-762-1597",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VELLEK",
        "first_name": "MARK",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-29",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "KY",
            "license": "C2194",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NV",
            "license": "20944",
            "primary": true
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MO",
            "license": "R5H89",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "171205",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MO",
            "identifier": "106095",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP",
            "identifier": "1210",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203284625",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "3604003",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCY HEALTH PLANS",
            "identifier": "F19081",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "65201A002",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063409688",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5132415",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.