Individual provider Active NPI

Mark Kline

  • Emergency Medicine Physician
  • Frederick, MD
National Provider Identifier
1194760595
Registry record updated Feb 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
C0001709 Issued in MD
Practice address
400 W 7TH St
Frederick, MD 21701-4506
Phone
(240) 566-3330
NPI assigned
Jun 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X C0001709 MD Primary

Addresses

Primary practice location

400 W 7TH St
Frederick, MD 21701-4506

Mailing address

PO Box 730
Frederick, MD 21705-0730
Phone (301) 631-9191

Other identifiers 1

IdentifierTypeStateIssuer
762671100MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050413001293 MD Practitioner - Physician Assistant 9537106208 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C0001709MDMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Urgent Care LLC CurrentSince Dec 1, 2020 Accepting new patients
Bestpractices, Inc. Emergency Medicine Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Bestpractices, Inc. Emergency Medicine Past Accepting new patients
Emergency Physician Associates, PA Past Accepting new patients

Locations

6317 York Rd
Baltimore, MD 21212
Phone (443) 777-6890

3064 Waldorf Market Pl
Waldorf, MD 20603
Phone (301) 932-5960

Organizations & group practices 6

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": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202169600000",
    "number": "1194760595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 730",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217050730",
            "telephone_number": "301-631-9191",
            "fax_number": "301-631-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W 7TH ST",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217014506",
            "telephone_number": "240-566-3330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINE",
        "first_name": "MARK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-19",
        "last_updated": "2008-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "C0001709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "762671100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.