Individual provider Active NPI

Mark J Hupert, M.D.

  • Infectious Disease Physician
  • Fort Worth, TX
National Provider Identifier
1265407761
Registry record updated Jan 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
L1619 Issued in TX
Practice address
1124 College Ave
Fort Worth, TX 76104-4557
Phone
(817) 348-0821
Fax
(817) 348-0073
NPI assigned
Feb 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X L1619 TX Primary

Addresses

Primary practice location

1124 College Ave
Fort Worth, TX 76104-4557

Mailing address

1125 College Ave
Fort Worth, TX 76104-4514
Phone (817) 348-0821

Other identifiers 3

IdentifierTypeStateIssuer
P00289085OtherMEDICARE RAILROAD
146391102MedicaidTX
8J8302OtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20051013000526 TX Practitioner - Infectious DiseasePractitioner - Internal Medicine 0941225429 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
University of Pittsburgh School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Centers for Infectious Disease Associates PAGroup PAC ID 4880596451, 17 clinicians

Practice addresses (Care Compare)

3410 Worth St
Suite 780
Dallas, TX 75246-2046
Phone (817) 810-9810

Hospital & facility affiliations

  • Texas Health Huguley Hospital Fort Worth South Hospital, Fort Worth, TX, CCN 450677
  • Baylor University Medical Center Hospital, Dallas, TX, CCN 450021

Merit-based Incentive Payment System (MIPS)

Final score
96.77 of 100Reported as group
Quality
92.76
Improvement activities
40
Cost
78.94

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Centers for Infectious Disease Associates PA Infectious Disease CurrentSince Nov 1, 2005 Accepting new patients
Tarrant County Infectious Disease Associates Infectious Disease PastSince Oct 6, 2019 Accepting new patients
DRS. Samuels & Huddleston, Apmc Past Accepting new patients
Tarrant County Infectious Disease Associates Infectious Disease Past Accepting new patients

Locations

3410 Worth St
Ste 780
Dallas, TX 75246
Phone (817) 810-9810

1025 College Ave
Fort Worth, TX 76104
Phone (817) 810-9810

1125 College Ave
Ft Worth, TX 76104
Phone (817) 336-1640

1124 College Ave
Ft Worth, TX 76104
Phone (817) 336-5466

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GCCBBA

Organizations & group practices 4

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1140393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358726400000",
    "number": "1265407761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 COLLEGE AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044514",
            "telephone_number": "817-348-0821",
            "fax_number": "817-348-0073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 COLLEGE AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044557",
            "telephone_number": "817-348-0821",
            "fax_number": "817-348-0073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUPERT",
        "first_name": "MARK",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-20",
        "last_updated": "2013-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "TX",
            "license": "L1619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00289085",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146391102",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8J8302",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.