NPIMap

Individual provider Active NPI

Mark W Puffenberger, M.D.

  • Family Medicine Physician
  • Petersburg, WV
National Provider Identifier
1124055314
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD040604E Issued in PA
Practice address
111 S Grove St Ste 1
Petersburg, WV 26847-1805
Phone
(304) 257-2451
Fax
(304) 257-1263
NPI assigned
Jun 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD040604E PA Primary

Addresses

Primary practice location

111 S Grove St Ste 1
Petersburg, WV 26847-1805

Mailing address

17978 Sr 55
Baker, WV 26801-0097
Phone (304) 897-5915

Other practice location 1

8 Lee St
Moorefield, WV 26836-1091
Phone (304) 538-7707

Other practice location 2

17978 Sr 55
Baker, WV 26801
Phone (304) 897-5915

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200407001770 WV Practitioner - Family Practice 2860564176 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Temple University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
E. a. Hawse Health Center, Inc. 19 clinicians

Practice addresses (Care Compare)

17978 Sr
Baker, WV 26801

17978 State Rd
Baker, WV 26801-8626
Phone (304) 897-5915

PO Box
Baker, WV 26801

PO Box
Baker, WV 26801-0097

Hospital & facility affiliations

  • Grant Memorial Hospital Hospital, Petersburg, WV, CCN 511316

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
E. a. Hawse Health Center, Inc. CurrentSince Mar 16, 2020 Accepting new patients
E.a. Hawse Health Center Inc Family Medicine CurrentSince Mar 16, 2020 Accepting new patients
E.a. Hawse Health Center Inc. Family Medicine Past Accepting new patients

Locations

17978 State Road 55
Baker, WV 26801
Phone (304) 897-8220

106 Harold K Michaels Dr
Mathias, WV 26812
Phone (304) 897-7400

8 Lee St
Moorefield, WV 26836
Phone (304) 538-7707

422 S Main St
Moorefield, WV 26836
Phone (304) 538-2331

111 S Grove St
Ste 1
Petersburg, WV 26847
Phone (304) 257-2451

Organizations & group practices 19

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.

View all 19

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": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1124055314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17978 SR 55",
            "city": "BAKER",
            "state": "WV",
            "postal_code": "268010097",
            "telephone_number": "304-897-5915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S GROVE ST STE 1",
            "city": "PETERSBURG",
            "state": "WV",
            "postal_code": "268471805",
            "telephone_number": "304-257-2451",
            "fax_number": "304-257-1263"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8 Lee St",
            "address_purpose": "LOCATION",
            "city": "Moorefield",
            "state": "WV",
            "postal_code": "268361091",
            "country_code": "US",
            "telephone_number": "304-538-7707",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17978 SR 55",
            "address_purpose": "LOCATION",
            "city": "BAKER",
            "state": "WV",
            "postal_code": "26801",
            "country_code": "US",
            "telephone_number": "304-897-5915",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUFFENBERGER",
        "first_name": "MARK",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD040604E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petersburg, WV

Sources for this page

Verify at the official NPI Registry.