Individual provider Active NPI

Mark H Lequire, M.D.

  • Diagnostic Radiology Physician
  • Montgomery, AL
National Provider Identifier
1336133735
Registry record updated Nov 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
00013481 Issued in AL
Practice address
2055 Normandie Dr
Suite 108
Montgomery, AL 36111-2732
Phone
(334) 288-4624
Fax
(334) 280-3628
NPI assigned
Aug 31, 2005
Last updated
Nov 2, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2011

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

Specialties & licenses 14

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 00013481 AL Primary
Diagnostic Radiology Physician 2085R0202X ME89827 FL
Diagnostic Radiology Physician 2085R0202X 20761 SC
Diagnostic Radiology Physician 2085R0202X 35-07-9272-L OH
Diagnostic Radiology Physician 2085R0202X 0000-39011 NC
Diagnostic Radiology Physician 2085R0202X H3097 TX
Diagnostic Radiology Physician 2085R0202X 34736 TN
Vascular & Interventional Radiology Physician 2085R0204X 00013481 AL
Vascular & Interventional Radiology Physician 2085R0204X ME89827 FL
Vascular & Interventional Radiology Physician 2085R0204X 20761 SC
Vascular & Interventional Radiology Physician 2085R0204X 35-07-9272-L OH
Vascular & Interventional Radiology Physician 2085R0204X 0000-39011 NC
Vascular & Interventional Radiology Physician 2085R0204X H3097 TX
Vascular & Interventional Radiology Physician 2085R0204X 34736 TN

Addresses

Primary practice location

2055 Normandie Dr
Suite 108
Montgomery, AL 36111-2732

Mailing address

2055 Normandie Dr
Suite 108
Montgomery, AL 36111-2732
Phone (334) 288-4624

Other identifiers 18

IdentifierTypeStateIssuer
000058866OtherALIDTF
009972715MedicaidAL
009928435MedicaidAL
009971800MedicaidAL
000058867OtherALIDTF
051551047MedicaidAL
107037MedicaidAL
009922335MedicaidAL
009930805MedicaidAL
009971820MedicaidAL
009971830MedicaidAL
051504364OtherALIDTF
107038MedicaidAL
108071MedicaidAL
009951085MedicaidAL
108246MedicaidAL
270021200MedicaidFL
009973725MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, NC2 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
I20041220001022 AL Practitioner - Diagnostic Radiology 5395727523 Reassigns benefits to 2 organizations
I20250321000103 NC Practitioner - Diagnostic Radiology 5395727523 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Alabama School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alabama Imaging PCGroup PAC ID 2365341328, 32 clinicians
Selma Radiology Associates P CGroup PAC ID 3870497720, 28 clinicians
Montgomery Radiology Associates PAGroup PAC ID 2961301999, 39 clinicians

Practice addresses (Care Compare)

Highlands, NC 28741
Phone (334) 269-6337

1015 Medical Ctr Pkwy
Selma, AL 36701-6748
Phone (334) 418-4100

105 US Hwy 80 E
Demopolis, AL 36732-3605
Phone (334) 289-4000

2000 Pepperell Pkwy
Opelika, AL 36801-5452
Phone (334) 269-6337

85 Sagee Dr
Highlands, NC 28741-8602
Phone (334) 269-6337

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0000-39011NCMDDiagnostic Radiology Physician
00013481ALMDVascular & Interventional Radiology Physician
ME89827FLMDVascular & Interventional Radiology Physician
H3097TXMDVascular & Interventional Radiology Physician
20761SCMDNurse Practitioner
34736TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Selma Radiology Associates P C CurrentSince Apr 21, 2003 Accepting new patients
Alabama Imaging PC CurrentSince Oct 1, 2004 Accepting new patients
Charlotte Radiology P a Past Accepting new patients
Open MRI of Tifton LLC PastSince Jun 1, 2007 Accepting new patients

Locations

105 US Highway 80 E
Demopolis, AL 36732
Phone (334) 287-2669

2055 Normandie Dr
Ste 108
Montgomery, AL 36111
Phone (334) 288-4624

2055 Normandie Dr
Ste 200
Montgomery, AL 36111
Phone (205) 262-0655

2105 E South Blvd
Montgomery, AL 36116
Phone (334) 286-2842

2000 Pepperell Pkwy
Opelika, AL 36801
Phone (334) 364-3300

1015 Medical Center Pkwy
Selma, AL 36701
Phone (334) 418-4100

Interoperability endpoints

  • Direct secure messaging: mark.lequire@direct.baptistfirst.org

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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.

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    "number": "1336133735",
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        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 NORMANDIE DR",
            "address_2": "SUITE 108",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361112732",
            "telephone_number": "334-288-4624",
            "fax_number": "334-280-3628"
        },
        {
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            "telephone_number": "334-288-4624",
            "fax_number": "334-280-3628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEQUIRE",
        "first_name": "MARK",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2011-11-02",
        "status": "A"
    },
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            "state": "TX",
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        },
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    "endpoints": [],
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}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.