Individual provider Active NPI

Mark Urbanski, DO

  • Hospitalist Physician
  • Prosper, TX
National Provider Identifier
1265896682
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
U9452 Issued in TX
Practice address
4100 W University Dr
Prosper, TX 75078-3123
Phone
(945) 204-4100
Fax
(682) 885-1903
NPI assigned
Apr 12, 2016
Last updated
May 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 5101024572 MI
Pediatrics Physician 208000000X 1265896682 IL
Hospitalist Physician 208M00000X U9452 TX Primary

Addresses

Primary practice location

4100 W University Dr
Prosper, TX 75078-3123

Mailing address

PO Box 733784
Dallas, TX 75373-3784
Phone (682) 885-6483

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address murbanski211614@CookChildrens.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190917002676 MI Practitioner - Pediatric Medicine 4183953169 Reassigns benefits to 1 organization
I20240403004049 TX Practitioner - Pediatric Medicine 4183953169 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1265896682ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan CurrentSince Jul 27, 2019 Accepting new patients
Regents of the University of Michigan Pediatrics CurrentSince Jul 27, 2019 Accepting new patients
Cook Children's Physician Network Pediatrics CurrentSince Apr 30, 2024 Accepting new patients
Cook Children's Physician Network Pediatrics CurrentSince Apr 30, 2024 Accepting new patients
Regents of the University of Michigan Pediatrics Current Accepting new patients
Cook Childrens Medical Center - Prosper Past Accepting new patients
Cook Children's Medical Center Past Accepting new patients

Locations

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

1051 N Canton Center Rd
Canton, MI 48187
Phone (734) 647-5670

801 7th Ave
Ft Worth, TX 76104
Phone (682) 885-4054

4100 W University Dr
Prosper, TX 75078
Phone (682) 303-4200

136 El Chico Trl
Ste 102
Willow Park, TX 76087
Phone (817) 441-5412

Interoperability endpoints

  • Direct secure messaging: murbanski211614@cookchildrens.direct-ci.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1460419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1265896682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 733784",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753733784",
            "telephone_number": "682-885-6483",
            "fax_number": "682-885-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 W UNIVERSITY DR",
            "city": "PROSPER",
            "state": "TX",
            "postal_code": "750783123",
            "telephone_number": "945-204-4100",
            "fax_number": "682-885-1903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URBANSKI",
        "first_name": "MARK",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-12",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "5101024572",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "1265896682",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TX",
            "license": "U9452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "murbanski211614@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "4100 W University Dr",
            "city": "Prosper",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750783123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Prosper, TX

Sources for this page

Verify at the official NPI Registry.