Active NPI
Mark M Mashike, D.C.
- Sports Physician Chiropractor
- San Diego, CA
National Provider Identifier
1407903602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physician Chiropractor
- License
- DC25982
- Practice address
- 12750 Carmel Country Rd Ste. A111
San Diego, CA 92130-2159 - Phone
- (858) 794-4007
- Fax
- (858) 792-4004
- NPI assigned
- Jan 3, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Sports Physician Chiropractor | 111NS0005X | DC25982 | CA | Primary |
Addresses
Primary practice location
12750 Carmel Country Rd Ste. A111
San Diego, CA 92130-2159
Mailing address
12750 Carmel Country Rd Ste A111
San Diego, CA 92130-2159
Phone (858) 794-4007
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200707002982 | CA | Practitioner - Chiropractic | 8022431279 |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
12750 Carmel Country Rd
Suite A111
San Diego, CA 92130-2159
Phone (858) 794-4007
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC25982 | CA | MD | Sports Physician Chiropractor |
| 25982 | CA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mark Mashike Chiropractic | Sports Physician | Current | Accepting new patients |
| Mark Mashike Chiropractic | Current | Accepting new patients |
Locations
12750 Carmel Country Rd
Ste A111
San Diego, CA 92130
Phone (858) 794-4007
Organizations & group practices 2
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.
-
- Clinic/Center
- San Diego, CA
- NPI 1730799115
-
- Sports Physician Chiropractor
- San Diego, CA
- NPI 1780294132
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1297900800000",
"number": "1407903602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12750 CARMEL COUNTRY RD STE A111",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921302159",
"telephone_number": "858-794-4007",
"fax_number": "858-792-4004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12750 CARMEL COUNTRY RD STE. A111",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921302159",
"telephone_number": "858-794-4007",
"fax_number": "858-792-4004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASHIKE",
"first_name": "MARK",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-03",
"last_updated": "2011-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "111NS0005X",
"taxonomy_group": "",
"desc": "Chiropractor, Sports Physician",
"state": "CA",
"license": "DC25982",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.