NPIMap

Individual provider Active NPI

Mark C Stickney, M.D.

  • Internal Medicine Physician
  • Rutland, VT
National Provider Identifier
1184633844
Registry record updated Nov 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
042-0007705 Issued in VT
Practice address
3 Commons St
Rutland, VT 05701-4652
Phone
(802) 773-7155
Fax
(802) 773-7616
NPI assigned
Aug 5, 2006
Last updated
Nov 24, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 042-0007705 VT Primary

Addresses

Primary practice location

3 Commons St
Rutland, VT 05701-4652

Mailing address

3 Commons St
Rutland, VT 05701-4652
Phone (802) 773-7155

Other identifiers 1

IdentifierTypeStateIssuer
0009219MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110110000061 VT Practitioner - Internal Medicine 4284823030 Practice locations: Rutland, VT; Woodstock, VT

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Albany Medical College of Union University, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

18 The GRN
Woodstock, VT 05091-1263
Phone (802) 457-2670

3 Commons St
Rutland, VT 05701-4652
Phone (802) 773-7155

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
24.13 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
80.42

Merit-based Incentive Payment System (MIPS)

Final score
83.39 of 100Reported as group
Quality
72.51
Promoting interoperability
100
Improvement activities
40
Cost
55.45

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
042-0007705VTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mark C. Stickney, MD, LLC Internal Medicine PastSince Dec 9, 2010 Accepting new patients

Organizations & group practices 1

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 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290556800000",
    "number": "1184633844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 COMMONS ST",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014652",
            "telephone_number": "802-773-7155",
            "fax_number": "802-773-7616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 COMMONS ST",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014652",
            "telephone_number": "802-773-7155",
            "fax_number": "802-773-7616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STICKNEY",
        "first_name": "MARK",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2010-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VT",
            "license": "042-0007705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009219",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rutland, VT

Sources for this page

Verify at the official NPI Registry.