Individual provider Active NPI

Mark Robert Sumers, M.D., D.P.M.

  • Family Medicine Physician
  • Tamc, HI
National Provider Identifier
1265495774
Registry record updated Sep 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
13281 Issued in HI
Practice address
1 Jarrett White Rd
Tripler Army Medical Center
Tamc, HI 96859-5001
Phone
(808) 433-3300
NPI assigned
Apr 7, 2006
Last updated
Sep 23, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2009

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301080614 MI
Family Medicine Physician 207Q00000X 13281 HI Primary
Family Medicine Physician 207Q00000X 34641 AZ
Podiatrist 213E00000X E3300 CA

Addresses

Primary practice location

1 Jarrett White Rd
Tripler Army Medical Center
Tamc, HI 96859-5001

Mailing address

1 Jarrett White Rd
Tripler Army Medical Center
Tamc, HI 96859-5001
Phone (808) 433-3300

Other identifiers 1

IdentifierTypeStateIssuer
4740479-10MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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
I20121213000242 HI Order and Referring Only - Family PracticePractitioner - Family Practice 9830135482

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13281HIMDFamily Medicine Physician
E3300CAMDPodiatrist

NPI Registry JSON

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253664000000",
    "number": "1265495774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 JARRETT WHITE RD",
            "address_2": "TRIPLER ARMY MEDICAL CENTER",
            "city": "TAMC",
            "state": "HI",
            "postal_code": "968595001",
            "telephone_number": "808-433-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 JARRETT WHITE RD",
            "address_2": "TRIPLER ARMY MEDICAL CENTER",
            "city": "TAMC",
            "state": "HI",
            "postal_code": "968595001",
            "telephone_number": "808-433-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMERS",
        "first_name": "MARK",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D., D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-07",
        "last_updated": "2009-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301080614",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "HI",
            "license": "13281",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "34641",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E3300",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4740479-10",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tamc, HI

Sources for this page

Verify at the official NPI Registry.