Mark Allen Siebrecht, D.P.M.
Individual provider Active NPI Foot & Ankle Surgery Podiatrist · Marengo, IA
NPI 1295724243 · NPPES record last updated Sep 23, 2013
Key facts
- NPI
- 1295724243
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Foot & Ankle Surgery Podiatrist 213ES0103X
- License
- 00701 (IA)
- Practice address
- 255 W. Lucas St.
Marengo, IA 52301 - Phone
- (319) 741-6789
- Fax
- (319) 741-6791
- NPI assigned
- Oct 20, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Podiatry
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Marengo Memorial Hospital
Practice addresses (Care Compare)
300 W May St
Marengo, IA 52301-1261
Phone 31964255438068
498 N Highland St
Williamsburg Family Medical Clinic
Williamsburg, IA 52361-9695
Phone 31964255438068
502 N 9TH Ave
Virginia Gay Hospital
Vinton, IA 52349-2254
Phone 31964255438068
Hospital & facility affiliations
- Compass Memorial Healthcare
- Virginia Gay Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of nail tissue | 264 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100310000564 | IA | Practitioner - Podiatry | 1759426158 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00701 | IA | MD | Foot & Ankle Surgery Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marengo Memorial Hospital | Current | Accepting new patients | |
| Marengo Memorial Hospital | Current |
Accepting new patients | |
| Marengo Memorial Hospital | Current |
Accepting new patients | |
| St Luke'S Methodist Hospital | Current | Accepting new patients | |
| Marengo Memorial Hospital | Past | Accepting new patients |
Locations
3207 220th Trl
Amana, IA 52203
Phone (319) 622-3131
1505 Sunset Dr
Belle Plaine, IA 52208
Phone (319) 444-2500
105 9th Ave
Belle Plaine, IA 52208
Phone (319) 444-2840
250 5th St
Keystone, IA 52249
Phone (319) 442-3234
255 W Lucas St
Marengo, IA 52301
Phone (319) 642-5213
300 W May St
Marengo, IA 52301
Phone (319) 462-8011
1500 Franklyn Ave
Marengo, IA 52301
Phone (319) 642-5533
300 W May St
Ste A
Marengo, IA 52301
Phone (319) 642-5543
150 W Washington St
North English, IA 52316
Phone (319) 664-3256
502 N 9th Ave
Vinton, IA 52349
Phone (319) 472-6200
1301 2nd Ave
Vinton, IA 52349
Phone (319) 472-4211
516 13th St
Wellman, IA 52356
Phone (319) 646-2911
100 Village View Cir
Williamsburg, IA 52361
Phone (319) 668-3800
498 N Highland St
Williamsburg, IA 52361
Phone 31964255438068
Interoperability endpoints
- msiebrecht168207@direct.unitypoint.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 00701 | IA | Yes |
Addresses
Primary practice location
255 W. Lucas St.
Marengo, IA 52301
Mailing address
255 W Lucas St
Marengo, IA 52301-1331
Phone (319) 741-6789
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 35111 | Other | IA | WELLMARK PROVIDER NUMBER |
| 2221713 | Medicaid | IA |
Other providers in Marengo, IA
- River Valley Dialysis LLC
- River Valley Family Chiropractic
- Karla Renee Robison
- Rose Haven Nursing Home Inc.
- Bobby Jo Salm
- State University of Iowa
- Switzer Counseling Services, LLC
- Kelli Sue Switzer
- Barbara Jean Taylor
- Thomas C Ryan
All providers in Marengo, IA · Foot & Ankle Surgery Podiatrist in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 23, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.