Individual provider Active NPI

Mark Leroy Andrews, MD

  • Family Medicine Physician
  • Roswell, NM
National Provider Identifier
1154420735
Registry record updated Jun 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
99-155 Issued in NM
Practice address
111 W. Hobbs St.
Roswell, NM 88203-1869
Phone
(575) 623-3311
Fax
(575) 622-1273
NPI assigned
Sep 21, 2006
Last updated
Jun 22, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2015

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 99-155 NM Primary

Addresses

Primary practice location

111 W. Hobbs St.
Roswell, NM 88203-1869

Mailing address

111 W Hobbs St
Roswell, NM 88203-1869
Phone (575) 623-3311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20080422000093 NM Practitioner - Family Practice 4385722073 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Northeastern Ohio University College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Roswell Osteopathic Medical Clinic, IncGroup PAC ID 2062312721, 2 clinicians

Practice addresses (Care Compare)

111 W Hobbs St
Roswell, NM 88203-1869
Phone (575) 623-3311

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Roswell Osteopathic Medical Clinic, Inc Family Medicine CurrentSince Jul 1, 2007 Accepting new patients
Medical Office Force CurrentSince Nov 1, 2022 Accepting new patients

Locations

2005 Prince Ave
Athens, GA 30606
Phone (706) 296-8632

111 W Hobbs St
Roswell, NM 88203
Phone (505) 623-3311

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434931200000",
    "number": "1154420735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W HOBBS ST",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882031869",
            "telephone_number": "575-623-3311",
            "fax_number": "575-622-1273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W. HOBBS ST.",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882031869",
            "telephone_number": "575-623-3311",
            "fax_number": "575-622-1273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDREWS",
        "first_name": "MARK",
        "middle_name": "LEROY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2015-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "99-155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, NM

Sources for this page

Verify at the official NPI Registry.