Individual provider Active NPI

Mark H Dean, D.O.

  • Interventional Pain Medicine Physician
  • Charlottesville, VA
National Provider Identifier
1265441083
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Practice address
630 Peter Jefferson Pkwy Ste 170
Charlottesville, VA 22911-4624
Phone
(434) 975-2555
Fax
(434) 974-6900
NPI assigned
Aug 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X VA Primary

Addresses

Primary practice location

630 Peter Jefferson Pkwy Ste 170
Charlottesville, VA 22911-4624

Mailing address

630 Peter Jefferson Pkwy Ste 170
Charlottesville, VA 22911-4624
Phone (434) 975-2555

Other identifiers 2

IdentifierTypeStateIssuer
177603OtherVAANTHEM
9831443OtherVACIGNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. 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 Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
102201203VAMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osteopathic Surgical Centers, LLC PastSince Jan 7, 2007 Accepting new patients
Osteopathic Physicians of Charlottesville Interventional Pain Medicine PastSince Jul 28, 2003 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265441083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 PETER JEFFERSON PKWY STE 170",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229114624",
            "telephone_number": "434-975-2555",
            "fax_number": "434-974-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 PETER JEFFERSON PKWY STE 170",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229114624",
            "telephone_number": "434-975-2555",
            "fax_number": "434-974-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAN",
        "first_name": "MARK",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "177603",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "9831443",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.