Mark Andrew Peckman, DO

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

34005181P Issued in OH

Practice address

400 Town Center Ave Ste 301
Columbiana, OH 44408-8312

Phone

(330) 482-3762

Fax

(330) 482-3840

NPI assigned

Sep 13, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Merit-based Incentive Payment System (MIPS)

Final score

84.84 of 100Reported as apm

Quality

69.69

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Independent Lab Services

  • Clinical Medical Laboratory
  • Youngstown, OH
  • NPI 1114329109
  NPD (past)

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1366437717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 TOWN CENTER AVE STE 301",
            "city": "COLUMBIANA",
            "state": "OH",
            "postal_code": "444088312",
            "telephone_number": "330-482-3762",
            "fax_number": "330-482-3840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 TOWN CENTER AVE STE 301",
            "city": "COLUMBIANA",
            "state": "OH",
            "postal_code": "444088312",
            "telephone_number": "330-482-3762",
            "fax_number": "330-482-3840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECKMAN",
        "first_name": "MARK",
        "middle_name": "ANDREW",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "OH",
            "license": "34005181P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0617176",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Mark.Peckman@salemregional.medicity.net",
            "affiliation": "N",
            "address_1": "400 Town Center Ave Ste 301",
            "city": "Columbiana",
            "state": "OH",
            "country_code": "US",
            "postal_code": "444088312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Omni Manor, Inc.
• Omni Manor, Inc.
• Derek Allen Ornelas, M.D.
• Andrew Padach
• Jeffrey Michael Palusak, D.D.S.
• Lance R Peterson, PT
• PM&R North, Inc.
• Stephen Raymond Predebon, MD
• Preferred Care Partners LLC
• Randall M Maceyko, OD

• Pain Medicine (Anesthesiology) Physician in Columbiana, OH
• Providers in Columbiana, OH by specialty
• Pain Medicine (Anesthesiology) Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2024; 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.