Mark Backman, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD00019350 Issued in WA

Practice address

1213 24TH St
#100
Anacortes, WA 98221-2592

Phone

(360) 293-3101

Fax

(360) 588-1041

NPI assigned

Nov 7, 2006

Last updated

Mar 19, 2009By 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)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Fidalgo Medical Associates PLLC

  • Family Medicine Physician
  • Anacortes, WA
  • NPI 1588749758
  NPD

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237420800000",
    "number": "1073682423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1213 24TH ST",
            "address_2": "#100",
            "city": "ANACORTES",
            "state": "WA",
            "postal_code": "982212592",
            "telephone_number": "360-293-3101",
            "fax_number": "360-588-1041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1213 24TH ST",
            "address_2": "#100",
            "city": "ANACORTES",
            "state": "WA",
            "postal_code": "982212592",
            "telephone_number": "360-293-3101",
            "fax_number": "360-588-1041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACKMAN",
        "first_name": "MARK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2009-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00019350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1789205",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dawn Asuncion, LMP
• Shana Susan Axelson
• Ashley Ayers, O.D.
• Jeren Babcock, PHARMD
• Angela Rose Babos, SUDP
• Kimberly A Baker, CP61009456
• Balanced Life Spa
• Thomas M Balestreri, MD
• Richard Baluyot, DO
• Kathryn Elieen Barnhart

• Family Medicine Physician in Anacortes, WA
• Providers in Anacortes, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.