Individual provider Active NPI

Mark H Pugh, DO

  • Psychiatry Physician
  • Lexington, KY
National Provider Identifier
1093919672
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
03648 Issued in KY
Practice address
1030 Monarch St
Lexington, KY 40513-1843
Phone
(606) 748-2523
NPI assigned
Jun 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X M5890 TX
Psychiatry Physician 2084P0800X 03648 KY Primary

Addresses

Primary practice location

1030 Monarch St
Lexington, KY 40513-1843

Mailing address

5096 Middleton PL
Lexington, KY 40515-1406
Phone (606) 748-2523

Other practice location 1

422 Sun River Ln
Dickinson, TX 77539-4175
Phone (281) 534-7059

Other practice location 2

9401 Southwest Fwy
Houston, TX 77074-1407
Phone (713) 970-3354

Other identifiers 1

IdentifierTypeStateIssuer
187757303MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20200611000245 FL Practitioner - Psychiatry 0244326981 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
03648KYMDPsychiatry Physician
M5890TXMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Connection, Inc Psychiatry CurrentSince Jun 16, 2024 Accepting new patients
Medication Assisted Recovery Institute, LLC Psychiatry CurrentSince May 27, 2020 Accepting new patients
Telecare Mental Health Services of Texas, Inc. Past Accepting new patients
Cyfair Psychiatry PA PastSince Dec 13, 2020 Accepting new patients
Ajinder S. Dhatt, MD, P.a. Psychiatry PastSince Oct 1, 2007 Accepting new patients
The Harris Center for Mental Health and Idd Past Accepting new patients

Locations

2900 N Military Trl
Ste 241
Boca Raton, FL 33431
Phone (561) 464-4949

5030 Champion Blvd
Ste G11
Boca Raton, FL 33496

5030 Champion Blvd
Ste G11535
Boca Raton, FL 33496

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/a1c02c8d-1bac-499e-a65c-6c958b95811a/

Organizations & group practices 6

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": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1093919672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5096 MIDDLETON PL",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405151406",
            "telephone_number": "606-748-2523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 MONARCH ST",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405131843",
            "telephone_number": "606-748-2523"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "422 Sun River Ln",
            "address_purpose": "LOCATION",
            "city": "Dickinson",
            "state": "TX",
            "postal_code": "775394175",
            "country_code": "US",
            "telephone_number": "281-534-7059",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9401 Southwest Fwy",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770741407",
            "country_code": "US",
            "telephone_number": "713-970-3354",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUGH",
        "first_name": "MARK",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-14",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "M5890",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KY",
            "license": "03648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "187757303",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.