NPIMap

Individual provider Active NPI

Mark E Hostettler, M.D.

  • Internal Medicine Physician
  • Alliance, OH
National Provider Identifier
1265431753
Registry record updated Mar 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35-05-2184-H Issued in OH
Practice address
1207 W State St
Suite N
Alliance, OH 44601-4686
Phone
(330) 821-3244
Fax
(330) 868-5782
NPI assigned
Jul 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35-05-2184-H OH Primary

Addresses

Primary practice location

1207 W State St
Suite N
Alliance, OH 44601-4686

Mailing address

1207 W State St
Suite N
Alliance, OH 44601-4686
Phone (330) 821-3244

Other identifiers 3

IdentifierTypeStateIssuer
000000269631OtherOHANTHEM
0690739MedicaidOH
110035014OtherOHMEDICARE RAILROADERS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060905000476 OH Practitioner - Internal Medicine 8325020167 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Manor Management Company IncGroup PAC ID 7012911209, 7 clinicians

Practice addresses (Care Compare)

1168 Alliance Rd NW
Minerva, OH 44657-8736
Phone (330) 868-3711

1207 W State St
Suite N
Alliance, OH 44601-4686
Phone (330) 821-3244

4080 Holiday St NW
Canton, OH 44718-2513
Phone (330) 492-8117

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Neurocare Sleep Center Past Accepting new patients
Alliance Medical Associates Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mark.hostettler.1@2706.direct.athenahealth.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • FHIR API: https://api.platform.athenahealth.com/22081/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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 5

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": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490832000000",
    "number": "1265431753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 W STATE ST",
            "address_2": "SUITE N",
            "city": "ALLIANCE",
            "state": "OH",
            "postal_code": "446014686",
            "telephone_number": "330-821-3244",
            "fax_number": "330-868-5782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 W STATE ST",
            "address_2": "SUITE N",
            "city": "ALLIANCE",
            "state": "OH",
            "postal_code": "446014686",
            "telephone_number": "330-821-3244",
            "fax_number": "330-868-5782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOSTETTLER",
        "first_name": "MARK",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2017-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35-05-2184-H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000269631",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0690739",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROADERS",
            "identifier": "110035014",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alliance, OH

Sources for this page

Verify at the official NPI Registry.