Mark S. Robertson, P.C.

Primary specialty

Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X

License

DO23994 Issued in OR

Legal business name

MARK S. ROBERTSON, P.C.

Practice address

950 29TH Ave SW
Albany, OR 97321-3415

Phone

(541) 967-0404

Fax

(541) 967-7072

NPI assigned

Feb 5, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Mark Stephen Robertson, D.O.NPI 1487679700

Title

Physician, Owner

Phone

(541) 967-0404

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark Stephen Robertson, D.O.

  • Otolaryngology/Facial Plastic Surgery Physician
  • Albany, OR
  • NPI 1487679700
  Medicare reassignment Care Compare group NPD Authorized official
• Ryan Richard Stevens, M.D.

  • Specialist
  • Corvallis, OR
  • NPI 1417938309
  Medicare reassignment Care Compare group NPD
• Julie Lam, PA-C

  • Physician Assistant
  • Ocala, FL
  • NPI 1215791751

  OR

  Medicare reassignment Care Compare group NPD
• Tiara F Packer, PA-C

  • Surgical Physician Assistant
  • Corvallis, OR
  • NPI 1447313010
  NPD (past)
• Sheri Lee Smith, MS, CCC-A

  • Audiologist
  • Corvallis, OR
  • NPI 1982785655
  NPD (past)

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590969600000",
    "number": "1205975588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 29TH AVE SW",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973213415",
            "telephone_number": "541-967-0404",
            "fax_number": "541-967-6548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 29TH AVE SW",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973213415",
            "telephone_number": "541-967-0404",
            "fax_number": "541-967-7072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK S. ROBERTSON, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2020-06-01",
        "certification_date": "2020-06-01",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "STEPHEN",
        "authorized_official_title_or_position": "PHYSICIAN, OWNER",
        "authorized_official_telephone_number": "541-967-0404",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "OR",
            "license": "DO23994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "286847",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Walter Manning, DMD
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• Deborah Marchino, FNP
• Heather Leigh Marcott, RN
• Marion Gregor and Associates, Inc
• Joann Markham
• Mariama Marong
• David Marshall
• Tera Marshall
• Wendy Lee Marshall, LMT

• Otolaryngology/Facial Plastic Surgery Physician in Albany, OR
• Providers in Albany, OR by specialty
• Otolaryngology/Facial Plastic Surgery Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.