Active NPI
Mark Pogue
- Oral & Maxillofacial Surgery (D.M.D.)
- Scottsdale, AZ
National Provider Identifier
1255327169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral & Maxillofacial Surgery (D.M.D.)
- License
- 26467
- Practice address
- 8535 E Hartford Dr
Scottsdale, AZ 85255-5438 - Phone
- (480) 515-5400
- Fax
- (480) 515-5493
- NPI assigned
- Sep 26, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral & Maxillofacial Surgery (D.M.D.) | 204E00000X | 26467 | AZ | Primary |
Addresses
Primary practice location
8535 E Hartford Dr
Scottsdale, AZ 85255-5438
Mailing address
8535 E Hartford Dr
Scottsdale, AZ 85255-5443
Phone (480) 515-5400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 31, 2022 through Dec 31, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26467 | AZ | MD | Oral & Maxillofacial Surgery (D.M.D.) |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Burt Faibisoff, MD, PLLC | 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 and National Provider Directory roles.
-
- Plastic Surgery Physician
- Lake Havasu City, AZ
- NPI 1336396761
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1331596800000",
"number": "1255327169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8535 E HARTFORD DR",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852555443",
"telephone_number": "480-515-5400",
"fax_number": "480-515-5493"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8535 E HARTFORD DR",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852555438",
"telephone_number": "480-515-5400",
"fax_number": "480-515-5493"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POGUE",
"first_name": "MARK",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-26",
"last_updated": "2012-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "204E00000X",
"taxonomy_group": "",
"desc": "Oral & Maxillofacial Surgery",
"state": "AZ",
"license": "26467",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scottsdale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.