Mark R Wells, PAC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

MA053486 Issued in PA

Practice address

208 Lifeline Rd
Ste 201
Stroudsburg, PA 18360-7566

Phone

(570) 476-6700

Fax

(570) 476-0124

NPI assigned

Sep 4, 2008

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 PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• St. Luke'S Physician Group, Inc.

  • Family Medicine Physician
  • Bethlehem, PA
  • NPI 1700984622
  Medicare reassignment
• St Luke'S Physician Group Inc

  • Family Medicine Physician
  • Orwigsburg, PA
  • NPI 1710845144
  NPD
• St. Luke'S Physician Group, Inc.

  • Internal Medicine Physician
  • Bethlehem, PA
  • NPI 1689256984
  NPD

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

{
    "created_epoch": "1220486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369094400000",
    "number": "1407004344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 LIFELINE RD",
            "address_2": "STE 201",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "183607566",
            "telephone_number": "570-476-6700",
            "fax_number": "570-476-0124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 LIFELINE RD",
            "address_2": "STE 201",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "183607566",
            "telephone_number": "570-476-6700",
            "fax_number": "570-476-0124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "MARK",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-04",
        "last_updated": "2013-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA053486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Warninger Healthcare
• Alexandra Dawn Wasmanski, OD
• Water Walkers Transitional Housing, Inc.
• Joan McCarthy Weglein, WHNP-BC
• Debra Weikert, LPC
• Robert James Welsh III, PHARMD
• Katrice Elaine Werley, PA-C
• Diane A. Whitcomb, CRNP
• Whitestone Healthcare Group, LLC
• Amanda Whitewood, PA-C

• Medical Physician Assistant in Stroudsburg, PA
• Providers in Stroudsburg, PA by specialty
• Medical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.