Mark W. Fugate, M.D.

Key facts

NPI

1124227459

Entity type

Individual (NPI type 1)

Primary specialty

Vascular Surgery Physician 2086S0129X

License

44206 (TN)

Practice address

2501 Citico Ave
Chattanooga, TN 37404-1127

Phone

(423) 697-2000

Fax

(423) 697-2320

NPI assigned

Jul 17, 2007

Sex

Male

Sole proprietor

No

Organizations & group practices 8

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.

• Memorial Health Partners Foundation, Inc Internal Medicine Physician · Chattanooga, TN · NPI 1922053545
  Medicare reassignment Care Compare group NPD GA · SURGERY · TN
• Chattanooga Hamilton County Hospital Authority Internal Medicine Physician · Chattanooga, TN · NPI 1154751931
  Medicare reassignment NPD SURGERY · TN
• Memorial Health Partners Foundation Inc Rural Health Clinic/Center · Trenton, GA · NPI 1467602482
  Care Compare group NPD
• Memorial Health Partners Foundation Inc Rural Health Clinic/Center · La Fayette, GA · NPI 1760632780
  Care Compare group NPD
• Memorial Health Partners Foundation Inc Rural Health Clinic/Center · Dayton, TN · NPI 1144633397
  Care Compare group
• Memorial Health Partners Foundation Inc Rural Health Clinic/Center · Spring City, TN · NPI 1477846954
  Care Compare group
• Chattanooga Hamilton County Hospital Authority Medicare Defined Swing Bed Hospital Unit · Pikeville, TN · NPI 1073622007
  NPD
• Memorial Health Care System Inc. General Acute Care Hospital · Chattanooga, TN · NPI 1255428736
  NPD (past)

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Memorial Health Care System Inc. General Acute Care Hospital · Hixson, TN · NPI 1083778633
  Care Compare affiliation Hospital
• Memorial Health Care System Inc. General Acute Care Hospital · Chattanooga, TN · NPI 1255428736
  Care Compare affiliation Hospital
• CHI Memorial Hospital - Georgia General Acute Care Hospital · Ringgold, GA · NPI 1356860621
  Care Compare affiliation Hospital
• Hartsville, LLC General Acute Care Hospital · Hartsville, SC · NPI 1174500458
  Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty

Vascular Surgery

Education

East Tennessee State University Quillen College of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Memorial Health Partners Foundation Inc (458 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Healthcare System, Inc Hospital · Chattanooga, TN · CCN 440091
• Commonspirit-Memorial Hospital-North Georgia Hospital · Ringgold, GA · CCN 110236
• Carolina Pines Regional Medical Center Hospital · Hartsville, SC · CCN 420010

Merit-based Incentive Payment System (MIPS)

Final score

94.27 of 100 (apm)

Quality

92.6

Promoting interoperability

93.23

Improvement activities

40

Procedures performed for Medicare patients

Medicare participation

Medicare fee-for-service enrollment

Enrolled (2 enrollments) in TN, GA

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: markfugate@tnmhpf.allscriptsdirect.net
• Direct secure messaging: mark.fugate.p1@direct.chattanoogaheart.nextgenshare.com
• Direct secure messaging: mfugate134940@direct.stlukeshealth.org

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 2, 2020.

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591056000000",
    "number": "1124227459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 CITICO AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041127",
            "telephone_number": "423-697-2000",
            "fax_number": "423-697-2118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 CITICO AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041127",
            "telephone_number": "423-697-2000",
            "fax_number": "423-697-2320"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2108 E 3rd St",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Chattanooga",
            "state": "TN",
            "postal_code": "374042600",
            "country_code": "US",
            "telephone_number": "423-267-0466",
            "fax_number": "423-493-2371",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FUGATE",
        "first_name": "MARK",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-17",
        "last_updated": "2020-06-02",
        "certification_date": "2020-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "MD44206",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "TN",
            "license": "44206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00741318",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4230402",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1515384",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "163534",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "540820812A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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