Mark Edwin Lightowler II, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5633 Issued in CT

Practice address

2800 Main St Dept of
Bridgeport, CT 06606-4201

Phone

(203) 392-3600

NPI assigned

Feb 21, 2019

Last updated

Oct 23, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Tufts University School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians

Connecticut Orthopaedic Specialists PCGroup PAC ID 7315850039, 184 clinicians

Midstate Medical CenterGroup PAC ID 7416840699, 187 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Vincent's Medical Center Hospital, Bridgeport, CT, CCN 070028

Merit-based Incentive Payment System (MIPS)

Final score

90.42 of 100Reported as group

Quality

83.36

Promoting interoperability

100

Improvement activities

40

Cost

75.9

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mlightowler446029@xdr.hhchealthdirect.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Connecticut Orthopaedic Specialists, PC

  • Orthopaedic Surgery Physician
  • Hamden, CT
  • NPI 1235181389
  Medicare reassignment Care Compare group NPD
• Hartford Healthcare Medical Group Specialists, PLLC

  • Surgery Physician
  • Hartford, CT
  • NPI 1023584216
  Medicare reassignment Care Compare group NPD
• Midstate Medical Center

  • General Acute Care Hospital
  • Meriden, CT
  • NPI 1154425288
  Medicare reassignment Care Compare group
• MHS Primary Care, Inc

  • Family Medicine Physician
  • Middletown, CT
  • NPI 1336279058

  Physician Assistant

  Medicare reassignment NPD
• Connecticut Orthopaedic Specialists, PC

  • Orthopaedic Surgery Physician
  • Fairfield, CT
  • NPI 1932614450

  Physician Assistant

  NPD
• Hartford Healthcare Medical Group Specialists LLC

  • Customized Equipment (DME)
  • Groton, CT
  • NPI 1295367068
  NPD
• Midstate Medical Center

  • Psychiatric Hospital Unit
  • Meriden, CT
  • NPI 1316022718
  NPD
• Midstate Medical Center

  • General Acute Care Hospital
  • Meriden, CT
  • NPI 1427007848
  NPD

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

• SVMC Holdings, Inc

  • General Acute Care Hospital
  • Bridgeport, CT
  • NPI 1942224696
  Care Compare affiliation

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

{
    "created_epoch": "1550707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1376000869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 MAIN ST DEPT OF",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066064201",
            "telephone_number": "203-362-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 MAIN ST DEPT OF",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066064201",
            "telephone_number": "203-392-3600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 N Colony Rd",
            "address_purpose": "LOCATION",
            "city": "Wallingford",
            "state": "CT",
            "postal_code": "064922407",
            "country_code": "US",
            "telephone_number": "203-265-1800",
            "fax_number": "203-284-9010",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "330 Bridgeport Ave",
            "address_purpose": "LOCATION",
            "city": "Shelton",
            "state": "CT",
            "postal_code": "064843861",
            "country_code": "US",
            "telephone_number": "203-538-0020",
            "fax_number": "203-538-0023",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "235 Boston Post Rd",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CT",
            "postal_code": "064773229",
            "country_code": "US",
            "telephone_number": "203-795-4784",
            "fax_number": "203-799-8370",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2416 Whitney Ave Fl 1",
            "address_purpose": "LOCATION",
            "city": "Hamden",
            "state": "CT",
            "postal_code": "065183248",
            "country_code": "US",
            "telephone_number": "203-407-3550",
            "fax_number": "203-407-4244",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "84 N Main St",
            "address_purpose": "LOCATION",
            "city": "Branford",
            "state": "CT",
            "postal_code": "064053061",
            "country_code": "US",
            "telephone_number": "203-483-2509",
            "fax_number": "203-483-2513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIGHTOWLER",
        "first_name": "MARK",
        "middle_name": "EDWIN",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-21",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "5633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dara Lieberson, MS, CLGC
• Jordan Taylor Liebman, PA-C
• Linda Liefland, PHD
• Lifebridge Community Services, Inc.
• Lifestyle Homecare Services
• John Salvatore Lignore, PA-C
• Letitia Z Lim, M.D.
• Wei Lin Lim, LCSW
• Karina K. Lincer
• Diana S Lindahl, APRN

• Physician Assistant in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.