Mark T. O'Brien, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101009744 Issued in MI

Practice address

1280 S 9TH St
Saint Clair, MI 48079-5368

Phone

(810) 326-0837

Fax

(810) 326-1534

NPI assigned

Nov 3, 2005

Last updated

Feb 25, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mobrien1143245@direct.hfhs.org

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.

• Henry Ford Health River District Hospital

  dba Henry Ford River District Hospital

  • Family Medicine Physician
  • East China, MI
  • NPI 1265486245
  Medicare reassignment NPD
• Seton Health Corporation of Southeastern Michigan

  • Family Medicine Physician
  • Clinton Township, MI
  • NPI 1598177065
  Medicare reassignment NPD
• Henry Ford Health River District Hospital

  • General Acute Care Hospital
  • East China, MI
  • NPI 1619941333
  NPD
• Seton Health Corporation of Southeastern Michigan

  dba Seton Medical Group Inc

  • Physical Therapy Clinic/Center
  • Macomb, MI
  • NPI 1487067260
  NPD
• Intercare Community Health Network

  • Federally Qualified Health Center (FQHC)
  • Bangor, MI
  • NPI 1326058512
  NPD (past)

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645747200000",
    "number": "1255322509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1280 S 9TH ST",
            "city": "SAINT CLAIR",
            "state": "MI",
            "postal_code": "480795368",
            "telephone_number": "810-326-0837",
            "fax_number": "810-326-1534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1280 S 9TH ST",
            "city": "SAINT CLAIR",
            "state": "MI",
            "postal_code": "480795368",
            "telephone_number": "810-326-0837",
            "fax_number": "810-326-1534"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4150 River Rd",
            "address_2": "Suite F2",
            "address_purpose": "LOCATION",
            "city": "East China",
            "state": "MI",
            "postal_code": "480542915",
            "country_code": "US",
            "telephone_number": "810-329-4660",
            "fax_number": "810-329-4699",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "MARK",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101009744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2662631",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Brianna Marie Palleschi, DC
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• Pdo LLC

• Family Medicine Physician in Saint Clair, MI
• Providers in Saint Clair, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.