NPIMap

Individual provider Active NPI

Mark Byron Jennings, MD

  • Internal Medicine Physician
  • Allen, TX
National Provider Identifier
1336379783
Registry record updated Sep 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
P1880 Issued in TX
Practice address
1105 Central Expy N Ste 235
Allen, TX 75013-6135
Phone
(972) 747-6042
Fax
(972) 747-6043
NPI assigned
Jul 20, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2012

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
Internal Medicine Physician 207R00000X P1880 TX Primary

Addresses

Primary practice location

1105 Central Expy N Ste 235
Allen, TX 75013-6135

Mailing address

1105 Central Expy N Ste 235
Allen, TX 75013-6135
Phone (972) 747-6042

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160713000303 OK Practitioner - Hematology/Oncology 8426204322 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
University of Oklahoma College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12697 E 51St St
Tulsa, OK 74146-6236
Phone (918) 505-3200

1301 W 6TH Ave
Stillwater, OK 74074-4381

417 Fairview Ave
Ponca City, OK 74601-1923
Phone (580) 762-3770

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.64 of 100Reported as individual
Quality
82.98
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
90.91 of 100Reported as apm
Quality
76.55
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P1880TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma Cancer Specialists and Research Institute LLC Current Accepting new patients
Tulsa Cancer Institute PLLC Current Accepting new patients
Stillwater Medical Center Authority Internal Medicine CurrentSince Feb 18, 2017 Accepting new patients
Oklahoma Cancer Specialists and Research Institute, LLC CurrentSince Aug 1, 2016 Accepting new patients
Stillwater Medical Center Authority CurrentSince Feb 18, 2017 Accepting new patients
Oklahoma Cancer Specialists and Research Institute LLC CurrentSince Aug 1, 2016 Accepting new patients
Oklahoma Cancer Specialists and Research Institute LLC Past Accepting new patients
Stillwater Medical Center Authority Past Accepting new patients

Locations

417 Fairview Ave
Ponca City, OK 74601
Phone (580) 762-3770

1301 W 6th Ave
Ste 208
Stillwater, OK 74074
Phone (405) 533-3010

12697 E 51st St
Tulsa, OK 74146
Phone (918) 505-3200

Interoperability endpoints

  • Direct secure messaging: mark.jennings.p1@direct.smc.nextgenshare.com

Organizations & group practices 8

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 7

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": "1248048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347408000000",
    "number": "1336379783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 CENTRAL EXPY N STE 235",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750136135",
            "telephone_number": "972-747-6042",
            "fax_number": "972-747-6043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 CENTRAL EXPY N STE 235",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750136135",
            "telephone_number": "972-747-6042",
            "fax_number": "972-747-6043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "MARK",
        "middle_name": "BYRON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-20",
        "last_updated": "2012-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "P1880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allen, TX

Sources for this page

Verify at the official NPI Registry.