Individual provider Active NPI

Mark M Chin, MD

  • Cardiovascular Disease Physician
  • Farmington, MO
National Provider Identifier
1104872381
Registry record updated Feb 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
36657 Issued in MO
Practice address
1103 W Liberty St
Farmington, MO 63640-1921
Phone
(573) 760-8488
Fax
(573) 756-3793
NPI assigned
May 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 36657 MO Primary

Addresses

Primary practice location

1103 W Liberty St
Farmington, MO 63640-1921

Mailing address

670 Mason Ridge Center Dr
Suite 300
Saint Louis, MO 63141-8573
Phone (573) 760-8488

Other identifiers 1

IdentifierTypeStateIssuer
202709200MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20050922000508 MO Practitioner - Cardiovascular Disease (Cardiology) 2860395548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heart and Vascular Associates LLCGroup PAC ID 7012208952, 6 clinicians

Practice addresses (Care Compare)

130 Westmount Dr
Farmington, MO 63640-2970
Phone (573) 756-1813

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.24 of 100Reported as group
Quality
82.48
Promoting interoperability
94
Improvement activities
40
Cost
76.66

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Heart and Vascular Associates LLC CurrentSince Oct 1, 2022 Accepting new patients
Physician Groups LC Cardiovascular Disease Past Accepting new patients
Department of Cardiology, LLC Cardiovascular Disease Past Accepting new patients
St. Lukes Medical Group Past Accepting new patients
Metro Heart Group of St. Louis, Inc. Past Accepting new patients

Locations

540 Maple Valley Dr
Farmington, MO 63640
Phone (573) 756-1813

130 Westmount Dr
Farmington, MO 63640
Phone (573) 756-1813

611 W Main St
Fredericktown, MO 63645
Phone (573) 773-7061

3015 N Ballas Rd
Saint Louis, MO 63131
Phone (314) 996-5330

Interoperability endpoints

  • Direct secure messaging: mchin11337@direct.carenet.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/HDFFAD

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 2

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": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329436800000",
    "number": "1104872381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 MASON RIDGE CENTER DR",
            "address_2": "SUITE 300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418573",
            "telephone_number": "573-760-8488",
            "fax_number": "573-756-3793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 W LIBERTY ST",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636401921",
            "telephone_number": "573-760-8488",
            "fax_number": "573-756-3793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIN",
        "first_name": "MARK",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2012-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MO",
            "license": "36657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202709200",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, MO

Sources for this page

Verify at the official NPI Registry.