Individual provider Active NPI

Mark A. Pithan, M.D.

  • Neurology Physician
  • Kamuela, HI
National Provider Identifier
1184680605
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
MD23591 Issued in HI
Practice address
65-1267 Kawaihae Rd
Kamuela, HI 96743-7345
Phone
(808) 881-4745
NPI assigned
Apr 24, 2006
Last updated
Oct 16, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X MD-44690 IA
Neurology Physician 2084N0400X MD23591 HI Primary

Addresses

Primary practice location

65-1267 Kawaihae Rd
Kamuela, HI 96743-7345

Mailing address

4700 E 56TH St Ste 100
Davenport, IA 52807-2904
Phone (563) 421-0480

Other practice location 1

4700 E 56th St Ste 100
Davenport, IA 52807-2904
Phone (563) 421-0480

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Mark.Pithan@direct.genesishealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, HI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180119000144 IA Practitioner - Neurology 4486713815 Reassigns benefits to 1 organization
I20241023002455 HI Practitioner - Neurology 4486713815 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Southern Illinois University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

67-1125 Mamalaho Hwy
Kamuela, HI 96743-8496
Phone (808) 881-4400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
34.85 of 100Reported as group
Quality
21.4
Improvement activities
0
Cost
76.92

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD23591HIMDNeurology Physician
MD-44690IAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Health System CurrentSince Oct 1, 2019 Accepting new patients
Queens North Hawaii Community Hospital CurrentSince Sep 1, 2024 Accepting new patients
Genesis Health System CurrentSince Oct 1, 2019 Accepting new patients
North Hawaii Community Hospital, Inc. CurrentSince Sep 1, 2024 Accepting new patients
Queens North Hawaii Community Hospital Past Accepting new patients
Wilmington ASC LLC Past Accepting new patients
Wilmington Health PLLC Past Accepting new patients

Locations

65-1267 Kawaihae Rd
Kamuela, HI 96743
Phone (808) 881-4745

67-1125 Mamalahoa Hwy
Kamuela, HI 96743
Phone (808) 881-4400

865 Lincoln Rd
Ste 100
Bettendorf, IA 52722
Phone (563) 355-1000

1351 W Central Park Ave
Ste 3300
Davenport, IA 52804
Phone (563) 383-2667

4700 E 56th St
Ste 100
Davenport, IA 52807
Phone (563) 383-2667

Networks

  • HI PPO

Interoperability endpoints

  • Direct secure messaging: mark.pithan@direct.genesishealth.com

Organizations & group practices 7

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 1

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": "1145836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1184680605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 E 56TH ST STE 100",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528072904",
            "telephone_number": "563-421-0480",
            "fax_number": "563-421-0489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65-1267 KAWAIHAE RD",
            "city": "KAMUELA",
            "state": "HI",
            "postal_code": "967437345",
            "telephone_number": "808-881-4745"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4700 E 56th St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Davenport",
            "state": "IA",
            "postal_code": "528072904",
            "country_code": "US",
            "telephone_number": "563-421-0480",
            "fax_number": "563-421-0489",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PITHAN",
        "first_name": "MARK",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-24",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IA",
            "license": "MD-44690",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "HI",
            "license": "MD23591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Mark.Pithan@direct.genesishealth.com",
            "affiliation": "N",
            "endpointDescription": "Genesis Health System Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "4700 E 56th St Ste 100",
            "city": "Davenport",
            "state": "IA",
            "country_code": "US",
            "postal_code": "528072904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kamuela, HI

Sources for this page

Verify at the official NPI Registry.