Mark L Miedema, M.D.

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

E-9691 Issued in AR

Practice address

3317 N Wimberly Dr
Fayetteville, AR 72703-4056

Phone

(479) 521-2752

Fax

(479) 443-7862

NPI assigned

Jun 17, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AR

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

Specialty

Physical Medicine and RehabilitationAlso: Pain Management

Education

University of Arkansas College of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ozark Physical Therapy Inc.Group PAC ID 1052400850, 44 clinicians

Ozark Orthopaedics, P.a.Group PAC ID 2860477189, 57 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Washington Regional Medical Center Hospital, Fayetteville, AR, CCN 040004
• Mercy Hospital Northwest Arkansas Hospital, Rogers, AR, CCN 040010
• Siloam Springs Regional Hospital Hospital, Siloam Springs, AR, CCN 040001
• Mercy Hospital Fort Smith Hospital, Fort Smith, AR, CCN 040062

Merit-based Incentive Payment System (MIPS)

Final score

91.41 of 100Reported as apm

Quality

79.26

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/18403/brand/1/csg/1/fhir/r4
• Direct secure messaging: mark.miedema.1@18403.direct.athenahealth.com

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.

• Ozark Orthopaedics, P.a.

  • Orthopaedic Surgery Physician
  • Fayetteville, AR
  • NPI 1649210584

  Physical Medicine & Rehabilitation

  Medicare reassignment Care Compare group NPD
• Ozark Physical Therapy Inc.

  • Physical Therapy Clinic/Center
  • Berryville, AR
  • NPI 1700843612
  Care Compare group
• Ozark Orthopaedics, PA

  • Orthopaedic Surgery Physician
  • Siloam Springs, AR
  • NPI 1255164570
  NPD
• Surgcenter of Fayetteville, LLC

  • Ambulatory Surgical Clinic/Center
  • Fayetteville, AR
  • NPI 1477178879
  NPD

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

• Mercy Hospital Fort Smith

  • General Acute Care Hospital
  • Fort Smith, AR
  • NPI 1568433480
  Care Compare affiliation
• Mercy Hospital Rogers

  • General Acute Care Hospital
  • Rogers, AR
  • NPI 1316902414
  Care Compare affiliation
• Siloam Springs Arkansas Hospital Company LLC

  • General Acute Care Hospital
  • Siloam Springs, AR
  • NPI 1902051816
  Care Compare affiliation
• Washington Regional Medical Center

  • General Acute Care Hospital
  • Fayetteville, AR
  • NPI 1083609150
  Care Compare affiliation

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

{
    "created_epoch": "1245196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1205063211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3317 N WIMBERLY DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034056",
            "telephone_number": "479-521-2752",
            "fax_number": "479-521-4603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3317 N WIMBERLY DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034056",
            "telephone_number": "479-521-2752",
            "fax_number": "479-443-7862"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 SE Moberly Ln",
            "address_purpose": "LOCATION",
            "city": "Bentonville",
            "state": "AR",
            "postal_code": "727127017",
            "country_code": "US",
            "telephone_number": "479-521-2752",
            "fax_number": "479-521-4603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIEDEMA",
        "first_name": "MARK",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-17",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "AR",
            "license": "E-9691",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "13487",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "CO",
            "license": "49437",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "AR",
            "license": "E-9691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mark.miedema.1@18403.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Athena Health direct email address for Orthopaedic Clinic LTD",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "3317 N Wimberly Dr",
            "city": "Fayetteville",
            "state": "AR",
            "country_code": "US",
            "postal_code": "727034056",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kiera Camille Michailoff-Russell, LPC
• Sophia J Michalak, LPC
• Desiree Carolina Middlebrook
• Anthony David Middleton
• Midtown Counseling
• Mike Buffington, M.D., P.a.
• Andrew Mikles
• Miles M Johnson, M.D. P.a.
• Millennium Dental, PLLC
• Millennium Dental, PLLC

• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.