Individual provider Active NPI

Mark Joseph Sulek, D.O.

  • Diagnostic Radiology Physician
  • Mason, OH
National Provider Identifier
1104809847
Registry record updated Jan 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
34005442S Issued in OH
Practice address
3922 Marquis LN
Mason, OH 45040-4110
Phone
(513) 225-4984
NPI assigned
Nov 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 34005442S OH Primary

Addresses

Primary practice location

3922 Marquis LN
Mason, OH 45040-4110

Mailing address

3922 Marquis LN
Mason, OH 45040-4110
Phone (513) 225-4984

Other identifiers 2

IdentifierTypeStateIssuer
P01419361OtherRR MEDICARE
2091892MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34005442SOHMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Radiology, Inc Diagnostic Radiology Past Accepting new patients
Medical Imaging Physicians Inc Diagnostic Radiology Past Accepting new patients
Anderson Radiology Associates LLP Diagnostic Radiology Past Accepting new patients
Usd Dayton, Inc. Diagnostic Radiology PastSince Oct 1, 2004 Accepting new patients
Midstates Radiology Consultants Diagnostic Radiology Past Accepting new patients
Scientific Medical Imaging, Inc. Past Accepting new patients

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": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453161600000",
    "number": "1104809847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3922 MARQUIS LN",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450404110",
            "telephone_number": "513-225-4984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3922 MARQUIS LN",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450404110",
            "telephone_number": "513-225-4984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULEK",
        "first_name": "MARK",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-28",
        "last_updated": "2016-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "34005442S",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01419361",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2091892",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mason, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2016; 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.