Active NPI
Mark H Dean, D.O.
- Interventional Pain Medicine Physician
- Charlottesville, VA
National Provider Identifier
1265441083
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Interventional Pain Medicine Physician
- 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
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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 177603 | Other | VA | ANTHEM |
| 9831443 | Other | VA | CIGNA |
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.
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 102201203 | VA | MD | Interventional Pain Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Osteopathic Surgical Centers, LLC | Past | Accepting new patients | |
| Osteopathic Physicians of Charlottesville | Interventional Pain Medicine | Past | 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.
-
- Interventional Pain Medicine Physician
- Charlottesville, VA
- NPI 1497765226
-
dba Charlottesville Surgical Center
- Ambulatory Surgical Clinic/Center
- Charlottesville, VA
- NPI 1598786477
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.