NPIMap

Individual provider Active NPI

Mark Queiros

  • Case Manager/Care Coordinator
  • Sandown, NH
National Provider Identifier
1154729861
Registry record updated Dec 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
03996 Issued in NH
Practice address
208 North Rd
Sandown, NH 03873-2003
Phone
(603) 887-6333
Fax
(603) 887-6900
NPI assigned
Dec 11, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X 03996 NH Primary

Addresses

Primary practice location

208 North Rd
Sandown, NH 03873-2003

Mailing address

208 North Rd
Sandown, NH 03873-2003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
03996NHMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Colonial Foxden Past Accepting new patients
Steven B. Patterson, Inc. Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1418256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418256000000",
    "number": "1154729861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 NORTH RD",
            "city": "SANDOWN",
            "state": "NH",
            "postal_code": "038732003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 NORTH RD",
            "city": "SANDOWN",
            "state": "NH",
            "postal_code": "038732003",
            "telephone_number": "603-887-6333",
            "fax_number": "603-887-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUEIROS",
        "first_name": "MARK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-11",
        "last_updated": "2014-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NH",
            "license": "03996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandown, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.