Active NPI
Craig Mark Mason, M.D.
- Ophthalmology Physician
- Fargo, ND
National Provider Identifier
1366428666
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 9082
- Practice address
- 2829 University Dr S Ste 204
Fargo, ND 58103-6050 - Phone
- (701) 293-9829
- Fax
- (701) 293-0111
- NPI assigned
- Dec 19, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 9082 | ND | Primary |
Addresses
Primary practice location
2829 University Dr S Ste 204
Fargo, ND 58103-6050
Mailing address
2829 University Dr S Ste 204
Fargo, ND 58103-6050
Phone (701) 293-9829
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 22104 | Other | ND | BLUE CROSS AND BLUE SHIEL |
| 11965 | Medicaid | ND | |
| 180045594 | Other | RAILROAD MEDICARE | |
| 0800996 | Other | MEDICA | |
| 214T1MA | Other | MN | BLUE CROSS AND BLUE SHIEL |
| 831015700 | Medicaid | MN | |
| 0144775 | Other | CIGNA | |
| 1031279 | Other | PREFERRED ONE | |
| 6300620 | Medicaid | SD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315526400000",
"number": "1366428666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2829 UNIVERSITY DR S STE 204",
"city": "FARGO",
"state": "ND",
"postal_code": "581036050",
"telephone_number": "701-293-9829",
"fax_number": "701-293-0111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2829 UNIVERSITY DR S STE 204",
"city": "FARGO",
"state": "ND",
"postal_code": "581036050",
"telephone_number": "701-293-9829",
"fax_number": "701-293-0111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASON",
"first_name": "CRAIG",
"middle_name": "MARK",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-12-19",
"last_updated": "2011-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Ophthalmology",
"state": "ND",
"license": "9082",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS AND BLUE SHIEL",
"identifier": "22104",
"state": "ND"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "11965",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "180045594",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "0800996",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS AND BLUE SHIEL",
"identifier": "214T1MA",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "831015700",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "0144775",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "1031279",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6300620",
"state": "SD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.