Individual provider Active NPI

Mark R Serpico, MD

  • Emergency Medicine Physician
  • Denver, CO
National Provider Identifier
1326535451
Registry record updated Mar 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A176193 Issued in CA
Practice address
777 Bannock St # Mc0108
Denver, CO 80204-4597
Phone
(303) 602-5183
NPI assigned
Apr 14, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X TL.0007151 CO
Emergency Medicine Physician 207P00000X A176193 CA Primary

Addresses

Primary practice location

777 Bannock St # Mc0108
Denver, CO 80204-4597

Mailing address

777 Bannock St # Mc0108
Denver, CO 80204-4507

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
I20220302002671 CA Practitioner - Emergency Medicine 4981098274 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Monterey Bay Observation MedicineGroup PAC ID 1052630514, 32 clinicians

Practice addresses (Care Compare)

23625 Holman Hwy
Monterey, CA 93940-5902
Phone (831) 625-4900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.49 of 100Reported as individual
Quality
97.98
Improvement activities
0
Cost
82.67

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A176193CAMDEmergency Medicine Physician
TL.0007151COMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Monterey Bay Observation Medicine Emergency Medicine CurrentSince Dec 6, 2022 Accepting new patients
Community Hospital of the Monterey Peninsula CurrentSince Jan 1, 2022 Accepting new patients
Community Hospital of the Monterey Peninsula CurrentSince Jan 1, 2022 Accepting new patients

Locations

23625 Wr Holman Hwy
Monterey, CA 93940
Phone (831) 622-2708

Organizations & group practices 3

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 2

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": "1523664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647993600000",
    "number": "1326535451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 BANNOCK ST # MC0108",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 BANNOCK ST # MC0108",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044597",
            "telephone_number": "303-602-5183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERPICO",
        "first_name": "MARK",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-14",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CO",
            "license": "TL.0007151",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A176193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.