Individual provider Active NPI

Mark Grayson Hall, MD

  • Surgery Physician
  • Wichita, KS
National Provider Identifier
1306475868
Registry record updated May 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
94-10298 Issued in KS
Practice address
1010 N Kansas St Ste 3023
Wichita, KS 67214-3124
Phone
(162) 932-6653
NPI assigned
Apr 6, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 94-10298 KS Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1010 N Kansas St Ste 3023
Wichita, KS 67214-3124

Mailing address

1010 N Kansas St Ste 3023
Wichita, KS 67214-3124
Phone (162) 932-6653

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20250626001802 CA Practitioner - General Surgery 2567887870 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2121 Santa Monica Blvd
Santa Monica, CA 90404-2303
Phone (310) 829-5511

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Saint Johns Medical Foundation CurrentSince Jun 30, 2025 Accepting new patients
Saint John'S Health Clinic Past Accepting new patients

Locations

2336 Santa Monica Blvd
Ste 204
Santa Monica, CA 90404
Phone (310) 453-4477

2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1586131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590537600000",
    "number": "1306475868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 N KANSAS ST STE 3023",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672143124",
            "telephone_number": "162-932-6653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 N KANSAS ST STE 3023",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672143124",
            "telephone_number": "162-932-6653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "MARK",
        "middle_name": "GRAYSON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-06",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KS",
            "license": "94-10298",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.