Mark Serra, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MED-PHYS-LIC-12100 Issued in MT

Practice address

350 Louisiana Avenue
Libby, MT 59923

Phone

(406) 283-7000

Fax

(406) 293-7931

NPI assigned

Aug 5, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MT

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

Emergency Medicine

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Johns Lutheran Hospital IncGroup PAC ID 1557255676, 34 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cabinet Peaks Medical Center Hospital, Libby, MT, CCN 271320

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• St. John'S Lutheran Hospital, Inc.

  • Critical Access Hospital
  • Libby, MT
  • NPI 1952312050
  Medicare reassignment Care Compare group NPD
• St John'S Lutheran Hospital Physician'S Services

  • Critical Access Hospital Clinic/Center
  • Libby, MT
  • NPI 1932253093
  NPD

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

• St. John'S Lutheran Hospital, Inc.

  • Critical Access Hospital
  • Libby, MT
  • NPI 1952312050
  Care Compare affiliation

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381276800000",
    "number": "1225229347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 LOUISIANA AVENUE",
            "city": "LIBBY",
            "state": "MT",
            "postal_code": "59923",
            "telephone_number": "406-283-7000",
            "fax_number": "406-293-7931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 LOUISIANA AVENUE",
            "city": "LIBBY",
            "state": "MT",
            "postal_code": "59923",
            "telephone_number": "406-283-7000",
            "fax_number": "406-293-7931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERRA",
        "first_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-05",
        "last_updated": "2013-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "L1169747",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MT",
            "license": "MED-PHYS-LIC-12100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Rose, LAC
• Christy M Rusdal, MPT, CSCS
• Rusty Ede DDS LLC
• Erin J Schmitt
• Senior Citizens of Lincoln County, Inc.
• Stephanie Lynn Shaw, SWLC
• Lorna M Shea, FNPC
• Mindy Sigea, SWLC
• Eric Charles Simpson, D.D.S.
• Samantha Kerper Smalley, DMD

• Emergency Medicine Physician in Libby, MT
• Providers in Libby, MT by specialty
• Emergency Medicine Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2013; 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.