Mark A Elliott, M.D.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

4301048994 Issued in MI

Practice address

1200 Sixth St
Suite 200
Traverse City, MI 49684-2369

Phone

(231) 935-5800

Fax

(231) 935-5799

NPI assigned

Sep 20, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: melliott@direct.mhc.net

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.

• Munson Medical Center

  • Endocrinology, Diabetes & Metabolism Physician
  • Traverse City, MI
  • NPI 1083761860
  Medicare reassignment NPD
• Munson Medical Center

  • Internal Medicine Physician
  • Traverse City, MI
  • NPI 1205864220

  Cardiovascular Disease

  NPD
• Munson Medical Center

  • Psychiatric Hospital Unit
  • Traverse City, MI
  • NPI 1891586103
  NPD
• Grand Traverse Heart Institute

  • Clinic/Center
  • Traverse City, MI
  • NPI 1801881461
  NPD (past)
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1184619744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2894 MOMENTUM PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606895328",
            "telephone_number": "231-935-6080",
            "fax_number": "231-935-6081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 SIXTH ST",
            "address_2": "SUITE 200",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842369",
            "telephone_number": "231-935-5800",
            "fax_number": "231-935-5799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "4301048994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2995933",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "melliott@direct.mhc.net",
            "affiliation": "N",
            "address_1": "1200 Sixth St",
            "address_2": "Suite 200",
            "city": "Traverse City",
            "state": "MI",
            "country_code": "US",
            "postal_code": "496842369",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Elizabeth G Bruning PHD PLLC
• Elizabeth McDonald Professional Counseling, LLC
• Amy Elkins
• Elizabeth Shannon Elliot, D.O.
• Clark A. Elliott, M.D.
• Alexandra Ellis
• Charlotte Lynn Ellis, PA
• Stephanie Ellis
• Katherine Renee Elms, M.D.
• Elmwood Charter Township

• Cardiovascular Disease Physician in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Cardiovascular Disease Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.