Mark D Byron, MD
Individual provider Active NPI Urology Physician · Jesup, GA
NPI 1154315877 · NPPES record last updated Jun 27, 2024
Key facts
- NPI
- 1154315877
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Urology Physician 208800000X
- License
- 47579 (GA)
- Practice address
- 825 S 1St St
Jesup, GA 31545 - Phone
- (912) 427-8033
- Fax
- (912) 427-7565
- NPI assigned
- Sep 8, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Urology
- Education
- St. Louis College of Physicians and Surgeons, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
162 Memorial Dr
Jesup, GA 31545-0101
825 S 1St St
Jesup, GA 31545-0209
Phone (912) 427-8033
Hospital & facility affiliations
- Wayne Memorial Hospital
- Memorial Satilla Health
- Candler Hospital
- Bacon County Hospital
- Appling Healthcare
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Prostate resection | 20 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111020000100 | GA | Practitioner - Urology | 3971775792 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 047579 | GA | MD | Specialist |
| 47579 | GA | MD | Urology Physician |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/GDGBBD/Endpoint/GDGBBD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 47579 | GA | Yes |
| Specialist | 174400000X | 047579 | GA |
Addresses
Primary practice location
825 S 1St St
Jesup, GA 31545
Mailing address
825 S 1St Street
Jesup, GA 31545
Phone (912) 427-8033
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00833599B | Medicaid | GA |
Other providers in Jesup, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 27, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.