Individual provider Active NPI

Mark B Richard, MD

  • Internal Medicine Physician
  • Derry, NH
National Provider Identifier
1356435655
Registry record updated Oct 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
9196 Issued in NH
Practice address
6 Tsienneto Road
Suite 300
Derry, NH 03038-0038
Phone
(603) 216-0400
Fax
(603) 216-3800
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 9196 NH Primary

Addresses

Primary practice location

6 Tsienneto Road
Suite 300
Derry, NH 03038-0038

Mailing address

6 Tsienneto Road
Suite 300
Derry, NH 03038-0038
Phone (603) 216-0400

Other identifiers 1

IdentifierTypeStateIssuer
30006796MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20040917000703 NH Practitioner - Internal Medicine 8224020961 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Massachusetts Medical School, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southern New Hampshire Internal Medicine Associates PCGroup PAC ID 9133111990, 16 clinicians

Practice addresses (Care Compare)

6 Tsienneto Rd
Suite 300
Derry, NH 03038-1584
Phone (603) 216-0400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southern New Hampshire Internal Medicine Associates, PLLC CurrentSince Apr 16, 2004 Accepting new patients

Locations

160 S River Rd
Ste 101A
Bedford, NH 03110
Phone (603) 216-3800

6 Tsienneto Rd
Ste 300
Derry, NH 03038
Phone (603) 216-0479

49 Range Rd
Ste 110
Windham, NH 03087

Interoperability endpoints

  • Direct secure messaging: markrichard@snhima.allscriptsdirect.net

Organizations & group practices 1

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225324800000",
    "number": "1356435655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 TSIENNETO ROAD",
            "address_2": "SUITE 300",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "030380038",
            "telephone_number": "603-216-0400",
            "fax_number": "603-216-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 TSIENNETO ROAD",
            "address_2": "SUITE 300",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "030380038",
            "telephone_number": "603-216-0400",
            "fax_number": "603-216-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARD",
        "first_name": "MARK",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2008-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NH",
            "license": "9196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30006796",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Derry, NH

Sources for this page

Verify at the official NPI Registry.