Mark Alan Wade, MD

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

4018 Issued in AK

Practice address

2310 Peger Rd
Ste 105
Fairbanks, AK 99709-5315

Phone

(907) 479-2663

Fax

(907) 479-2691

NPI assigned

Apr 26, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in AK

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

Specialty

Orthopedic Surgery

Education

University of Texas Medical Branch at Galveston, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orthopedic and Sportsmedicine Clinic of Fairbanks LLCGroup PAC ID 8820470636, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fairbanks Memorial Hospital Hospital, Fairbanks, AK, CCN 020012

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Orthopedic & Sportsmedicine Clinic of Fairbanks LLC

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Fairbanks, AK
  • NPI 1689304982
  Medicare reassignment Care Compare group NPD
• Fairbanks Clinic Inc

  • Clinic/Center
  • Fairbanks, AK
  • NPI 1073636148
  NPD (past)
• Comanche County Medical Center Company

  • Emergency Medicine Physician
  • Comanche, TX
  • NPI 1184695231
  NPD (past)
• Comanche County Medical Center Company

  • Rural Health Clinic/Center
  • Comanche, TX
  • NPI 1659054005
  NPD (past)

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

• Fairbanks Memorial Hospital, LLC

  • General Acute Care Hospital
  • Fairbanks, AK
  • NPI 1720537178
  Care Compare affiliation

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366243200000",
    "number": "1356307458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 PEGER RD",
            "address_2": "STE 105",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997095315",
            "telephone_number": "907-479-2663",
            "fax_number": "907-479-2691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 PEGER RD",
            "address_2": "STE 105",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997095315",
            "telephone_number": "907-479-2663",
            "fax_number": "907-479-2691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "MARK",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2013-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AK",
            "license": "4018",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "AK",
            "license": "4018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD07391",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR ID",
            "identifier": "194028200",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD07392",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD6149",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Jon Voorhees, PA-C
• Erica Vorisek
• W. Lee Payne, DDS, PC
• Rebecca Wachter
• Janeanica Wade
• Tancen Wade
• Amy Louise Wagner, MA
• Erica Wagner, LMT
• Kimberly Wagner, B.S.
• Lejeana Wagner

• Sports Medicine (Orthopaedic Surgery) Physician in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.