Mark Cross, PA-C
Individual provider Active NPI Physician Assistant · Coeur D Alene, ID
NPI 1205964939 · NPPES record last updated Jun 2, 2026
Key facts
- NPI
- 1205964939
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA-1548 (ID)
- Practice address
- 2426 N Merritt Creek Loop Ste a
Coeur D Alene, ID 83814-4961 - Phone
- (208) 819-2183
- Fax
- (208) 209-6063
- NPI assigned
- Mar 2, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 14
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Sequoia Healthcare Alliance
Practice addresses (Care Compare)
560 W Putnam Ave
Porterville, CA 93257-3269
Phone (559) 784-5337
Hospital & facility affiliations
- Sierra View Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CA, ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081114000107 | CA | Practitioner - Physician Assistant | 2365548690 | Reassigns benefits to 4 organizations |
| I20260610000971 | ID | Practitioner - Physician Assistant | 2365548690 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19505 | CA | MD | Emergency Medicine Physician |
| PA-1548 | ID | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sequoia Healthcare Alliance | Current |
Accepting new patients | |
| Santa Barbara County Auditor | Current |
Accepting new patients | |
| Santa Barbara County Department of Behavioral Wellness | Current |
Accepting new patients | |
| Community Health Centers of the Central Coast Inc | Current |
Accepting new patients | |
| Community Health Centers of the Central Coast Inc | Current | Accepting new patients | |
| Community Health Centers of the Central Coast, Inc | Current |
Accepting new patients | |
| Community Health Centers of the Central Coast Inc | Current | Accepting new patients | |
| Sequoia Family Medical Center, Inc | Past | Accepting new patients | |
| Fortuna Family Medical Group Inc | Past | Accepting new patients | |
| Senior Care of Colorado, PC | Physician Assistant | Past |
Accepting new patients |
Locations
4723 W Main St
Ste H
Guadalupe, CA 93434
Phone (805) 343-2004
150 Tejas Pl
Nipomo, CA 93444
Phone (805) 929-3254
585 W Putnam Ave
Porterville, CA 93257
Phone (559) 359-4415
590 W Putnam Ave
Porterville, CA 93257
Phone (559) 781-3700
560 W Putnam Ave
Porterville, CA 93257
Phone (559) 782-1807
4444 Calle Real
Santa Barbara, CA 93110
Phone (805) 681-5190
429 N San Antonio Rd
Santa Barbara, CA 93110
Phone (805) 884-1600
2801 Santa Maria Way
Bldg A
Santa Maria, CA 93455
Phone (805) 938-9200
2050 S Blosser Rd
Santa Maria, CA 93458
Phone (805) 361-8014
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA-1548 | ID | Yes |
Addresses
Primary practice location
2426 N Merritt Creek Loop Ste a
Coeur D Alene, ID 83814-4961
Mailing address
PO Box 3687
Coeur D Alene, ID 83816-2529
Phone (208) 819-2183
Other providers in Coeur D Alene, ID
- David Leroy Crettol
- Richard V Cripe
- Jonathan David Crisman
- Krista L Criswell
- Karyn L Crone
- Theresa Cross
- Carol J Croteau
- Briana Crotinger
- Pamela Diane Crowe
- Kari Crowell-Longman
All providers in Coeur D Alene, ID · Physician Assistant in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 2, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.