Individual provider Active NPI

Mark M Mashike, D.C.

  • Sports Physician Chiropractor
  • San Diego, CA
National Provider Identifier
1407903602
Registry record updated Feb 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
DC25982 Issued in CA
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

Updated by the provider on Feb 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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 IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
DC25982CAMDSports Physician Chiropractor
25982CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mark Mashike Chiropractic Sports Physician CurrentSince Aug 2, 2020 Accepting new patients
Mark Mashike Chiropractic CurrentSince Jun 24, 2020 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.

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.

Verify at the official NPI Registry.