Mark A. Flores, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA10005173 Issued in WA

Practice address

237 Professional Way
Shelton, WA 98584-4404

Phone

(360) 426-2500

NPI assigned

May 3, 2007

Last updated

Jan 23, 2008By the provider in NPPES

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)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Olympic Physicians P.L.L.C.

  • Primary Care Clinic/Center
  • Shelton, WA
  • NPI 1417156183
  NPD (past)
• South Sound Family & Sports

  • Family Medicine Physician
  • Olympia, WA
  • NPI 1558446211
  NPD (past)
• South Sound Health & Fitness

  • Physical Therapy Clinic/Center
  • Olympia, WA
  • NPI 1396914628
  NPD (past)

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201046400000",
    "number": "1063634277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 PROFESSIONAL WAY",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985844404",
            "telephone_number": "360-426-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "237 PROFESSIONAL WAY",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985844404",
            "telephone_number": "360-426-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLORES",
        "first_name": "MARK",
        "middle_name": "A.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2008-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA10005173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8481137",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fir Lane Health - Shelton, LLC
• Fir Lane Health-Shelton,LLC (Fir Lane Health & Rehabilitation Center)
• Fire Protection Dist 5 Mason County (Central Mason Fire & EMS)
• Lux Reyes Fisher, PHD
• Raymond Flick
• Ronald Flores
• Fly Free Wellness Center (FLY Free)
• FMG North 13TH Street Washington
• Karen Lynne Foreman
• Casey Forsyth, CASAC, SUDP

• Medical Physician Assistant in Shelton, WA
• Providers in Shelton, WA by specialty
• Medical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.