Mark Flynn Mavilia, FNP-BC
Individual provider Active NPI Family Nurse Practitioner · Belmont, NH
NPI 1306204284 · NPPES record last updated Nov 16, 2023
Key facts
- NPI
- 1306204284
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- RN276152 (MA)
- Practice address
- 77 Daniel Webster Hwy
Belmont, NH 03220-3028 - Phone
- (603) 737-0500
- Fax
- (603) 737-8331
- NPI assigned
- Feb 5, 2016
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 7
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Convenientmd - FFS UC LLC
Practice addresses (Care Compare)
77 Daniel Webster Hwy
Belmont, NH 03220-3028
Phone (603) 737-0550
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200113001164 | NH | Practitioner - Nurse Practitioner | 4486940020 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Convenientmd - FFS UC LLC | Current | Accepting new patients | |
| Convenientmd - FFS UC LLC | Current |
Accepting new patients | |
| Convenientmd - FFS UC LLC | Current |
Accepting new patients | |
| Steward Medical Group, Inc | Past | Accepting new patients | |
| Convenientmd - FFS UC LLC | Past | Accepting new patients |
Locations
3 Nashua Rd
Bedford, NH 03110
Phone (603) 472-6700
77 Daniel Webster Hwy
Belmont, NH 03220
Phone (603) 737-0500
111 New Hampshire Ave
Portsmouth, NH 03801
360 US Highway 1 Byp
Unit 102
Portsmouth, NH 03801
Phone (603) 410-6700
125 Indian Rock Rd
Windham, NH 03087
Phone (603) 890-6330
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN276152 | MA | Yes |
Addresses
Primary practice location
77 Daniel Webster Hwy
Belmont, NH 03220-3028
Mailing address
360 US Highway 1 Byp Unit 102
Portsmouth, NH 03801-7105
Phone (603) 410-6700
Other providers in Belmont, NH
- Leah J Link
- Audrey Lloyd
- LRGH Rehabilitation Services
- Caitlin Ruth Macdonald
- Elizabeth Marceau
- Fred McDonald
- Megan Ashley McGann
- Heather Marie Melanson-Levy
- Mill Plaza Dental Associates PLLC
- Antoinette Marie Mills
All providers in Belmont, NH · Family Nurse Practitioner in New Hampshire
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 16, 2023. 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.