Individual provider Active NPI

Mark Thomas Hastings, D.P.M.

  • Podiatrist
  • Lake Oswego, OR
National Provider Identifier
1073609640
Registry record updated Mar 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
DP00284 Issued in OR
Practice address
16316 Bryant Rd
Lake Oswego, OR 97035-4308
Phone
(503) 699-8220
Fax
(503) 699-7949
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X DP00284 OR Primary

Addresses

Primary practice location

16316 Bryant Rd
Lake Oswego, OR 97035-4308

Mailing address

16316 Bryant Rd
Lake Oswego, OR 97035-4308
Phone (503) 699-8220

Other identifiers 1

IdentifierTypeStateIssuer
158759MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101028000209 OR Practitioner - Podiatry 9931393584 Reassigns benefits to 1 organization
Practice locations: Lake Osweo, OR

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

9155 SW Barnes Rd
Suite 318
Portland, OR 97225-6630
Phone (503) 467-4761

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.26 of 100Reported as apm
Quality
84.3
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue59
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services Oregon CurrentSince Dec 2, 2024 Accepting new patients
Providence Health & Services Oregon CurrentSince Dec 2, 2024 Accepting new patients
Providence Health & Services - Oregon Past Accepting new patients
Providence Health & Services - Oregon Past Accepting new patients

Locations

9155 SW Barnes Rd
Ste 318
Portland, OR 97225
Phone (503) 467-4761

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

Interoperability endpoints

  • Direct secure messaging: mhastings101816@oc.providencedirect.org

Organizations & group practices 5

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 1

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394236800000",
    "number": "1073609640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16316 BRYANT RD",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970354308",
            "telephone_number": "503-699-8220",
            "fax_number": "503-699-7949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16316 BRYANT RD",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970354308",
            "telephone_number": "503-699-8220",
            "fax_number": "503-699-7949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASTINGS",
        "first_name": "MARK",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2014-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OR",
            "license": "DP00284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158759",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Oswego, OR

Sources for this page

Verify at the official NPI Registry.