Mark B Pardoe, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

A78580 Issued in CA

Practice address

2752 Harrison Ave
Suite a
Eureka, CA 95501-4738

Phone

(707) 445-3075

Fax

(707) 445-3076

NPI assigned

Oct 25, 2006

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Plastic and Reconstructive Surgery

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence at Home With Compassus Home Health, Humboldt Home health agency, Eureka, CA, CCN 057256
• Providence St Joseph Hospital Hospital, Eureka, CA, CCN 050006
• Mad River Community Hospital Hospital, Arcata, CA, CCN 050028

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mpardoe1658141@oc.providencedirect.org

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.

• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  Medicare reassignment Care Compare group NPD (past)
• Providence Medical Foundation

  • General Practice Physician
  • Diamond Bar, CA
  • NPI 1285890624
  NPD
• Providence Medical Foundation

  • Surgery Physician
  • Eureka, CA
  • NPI 1477790517
  NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1639715709
  NPD
• Providence Medical Institute

  • Family Medicine Physician
  • Torrance, CA
  • NPI 1235182569
  NPD (past)
• Russel Pardoe, M.D., Inc.

  • Specialist
  • Eureka, CA
  • NPI 1992918551

  Plastic Surgery

  NPD (past)
• St. Joseph Health Northern California, LLC

  • General Acute Care Hospital
  • Eureka, CA
  • NPI 1609858950
  NPD (past)

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

• American Hospital Management Corporation

  • General Acute Care Hospital
  • Arcata, CA
  • NPI 1518996040
  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  • Home Infusion Therapy Pharmacy
  • Eureka, CA
  • NPI 1568422319

  Hospital

  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  • General Acute Care Hospital
  • Eureka, CA
  • NPI 1609858950
  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  • General Acute Care Hospital
  • Eureka, CA
  • NPI 1891900635
  Care Compare affiliation
• St. Joseph Home Care Network

  • Home Health Agency
  • Eureka, CA
  • NPI 1144315052
  Care Compare affiliation

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1407930209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2752 HARRISON AVE",
            "address_2": "SUITE A",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955014738",
            "telephone_number": "707-445-3075",
            "fax_number": "707-445-3076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2752 HARRISON AVE",
            "address_2": "SUITE A",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955014738",
            "telephone_number": "707-445-3075",
            "fax_number": "707-445-3076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARDOE",
        "first_name": "MARK",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A78580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A785800",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mpardoe1658141@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "2460 Buhne St",
            "city": "Eureka",
            "state": "CA",
            "country_code": "US",
            "postal_code": "955013207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rachael R Pangborn, RN
• Alyssa Panozzo, PA-C
• Jack Panting
• Eileen Rose Panza, PA
• Cameron Papp
• Rebecca Pardoe, PT
• Hannah Lyn Park
• Hyun Soo Park, MD
• Crystal Marie Parker
• Elizabeth Anne Parker, FNP

• Plastic Surgery Physician in Eureka, CA
• Providers in Eureka, CA by specialty
• Plastic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; 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.