NPIMap

Individual provider Active NPI

Mark D Kochenderfer, MD

  • Hematology & Oncology Physician
  • Roanoke, VA
National Provider Identifier
1396720454
Registry record updated Feb 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
0101244463 Issued in VA
Practice address
2013 Jefferson St SW
Roanoke, VA 24014-2419
Phone
(540) 982-0237
Fax
(540) 982-0103
NPI assigned
Dec 13, 2005
Last updated
Feb 5, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 0101244463 VA Primary

Addresses

Primary practice location

2013 Jefferson St SW
Roanoke, VA 24014-2419

Mailing address

2013 Jefferson St SW
Roanoke, VA 24014-2419
Phone (540) 982-0237

Other identifiers 2

IdentifierTypeStateIssuer
1396720454OtherVAANTHEM
1396720454MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090115000721 VA Practitioner - Hematology/Oncology 8628006129 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
West Virginia University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2013 Jefferson St SW
Roanoke, VA 24014-2419
Phone (540) 982-0237

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as apm

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101244463VAMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oncology and Hematology Associates of Southwest Virginia, Inc. Hematology & Oncology CurrentSince Jan 1, 2009 Accepting new patients
Oncology and Hematology Associates of Southwest Virginia, Inc. CurrentSince Jan 1, 2009 Accepting new patients
Pinehurst Medical Clinic, Inc. Hematology & Oncology Past Accepting new patients

Locations

1710 Whitfield Dr
Bedford, VA 24523
Phone (540) 586-0636

108 Houston St
Ste B
Lexington, VA 24450
Phone (540) 463-2227

1 Arh Ln
Ste 300
Low Moor, VA 24457
Phone (540) 862-6223

2013 Jefferson St SW
Roanoke, VA 24014
Phone (540) 982-0237

2013 Jefferson St SW
Fl 2
Roanoke, VA 24014
Phone (540) 982-0237

390 S Main St
Ste 103
Rocky Mount, VA 24151
Phone (540) 489-6522

1900 Electric Rd
Salem, VA 24153
Phone (540) 772-3400

1995 W Ridge Rd
Wytheville, VA 24382
Phone (276) 223-1983

Interoperability endpoints

  • Direct secure messaging: mark.kochenderfer@brcc.ikm.direct-ci.com

Organizations & group practices 3

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.

Hospital & facility affiliations 8

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": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360022400000",
    "number": "1396720454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2013 JEFFERSON ST SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240142419",
            "telephone_number": "540-982-0237",
            "fax_number": "540-982-0103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2013 JEFFERSON ST SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240142419",
            "telephone_number": "540-982-0237",
            "fax_number": "540-982-0103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCHENDERFER",
        "first_name": "MARK",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-13",
        "last_updated": "2013-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "VA",
            "license": "0101244463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "1396720454",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396720454",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.