Individual provider Active NPI

C Mark Capistrano, MD

  • Hematology & Oncology Physician
  • Bryan, TX
National Provider Identifier
1205905494
Registry record updated Jul 8, 2007
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128a(4) exclusion effective Feb 20, 2022.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
J8943 Issued in TX
Practice address
3201 University Dr E
Suite 250
Bryan, TX 77802-3475
Phone
(979) 731-8558
Fax
(979) 731-8654
NPI assigned
Nov 6, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X J8943 TX Primary

Addresses

Primary practice location

3201 University Dr E
Suite 250
Bryan, TX 77802-3475

Mailing address

3201 University Dr E
Suite 250
Bryan, TX 77802-3475
Phone (979) 731-8558

Other identifiers 1

IdentifierTypeStateIssuer
8V4920OtherTXBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

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. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
J8943TXMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Avi B Markowitz, MD, PA Hematology & Oncology Past 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.

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205905494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 UNIVERSITY DR E",
            "address_2": "SUITE 250",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778023475",
            "telephone_number": "979-731-8558",
            "fax_number": "979-731-8654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 UNIVERSITY DR E",
            "address_2": "SUITE 250",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778023475",
            "telephone_number": "979-731-8558",
            "fax_number": "979-731-8654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPISTRANO",
        "first_name": "C",
        "middle_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "TX",
            "license": "J8943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8V4920",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

Verify at the official NPI Registry.