Active NPI
John Mark Pettit, MD
- Urology Physician
- Bellingham, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- MD00024911
- Practice address
- 340 Birchwood Ave
Bellingham, WA 98225-1782 - Phone
- (360) 671-9197
- Fax
- (360) 676-7730
- NPI assigned
- Oct 18, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | MD00024911 | WA | Primary |
| Urology Physician | 208800000X | MD494768 | PA | |
| Urology Physician | 208800000X | 78751 | AZ |
Addresses
Primary practice location
340 Birchwood Ave
Bellingham, WA 98225-1782
Mailing address
340 Birchwood Ave
Bellingham, WA 98225-1782
Phone (360) 671-9197
Other practice location 1
269 S Candy Ln
Cottonwood, AZ 86326-4158
Phone (928) 649-7970
Other practice location 2
25 Monument Rd Ste 190
York, PA 17403-5059
Phone (717) 741-8011
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1032978 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA, PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Urology
- Education
- Other, 1981
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
25 Monument Rd
Suite 190
York, PA 17403-5059
Phone (717) 741-8011
Hospital & facility affiliations
- Wellspan York Hospital
- Verde Valley Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 86.37 of 100
- Quality
- 81.09
- Improvement activities
- 40
- Cost
- 79.8
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 78751 | AZ | MD | Urology Physician |
| MD494768 | PA | MD | Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northern Arizona Healthcare Corporation | Current | Accepting new patients | |
| Northern Arizona Healthcare Corporation | Urology | Current | Accepting new patients |
| Bellingham Ear Nose Throat & Facial Plastic Surgery Inc PS | Past | Accepting new patients | |
| Walk in Health Clinic | Past | Accepting new patients | |
| Pacific Northwest Urology Specialists, PLLC | Past | Accepting new patients | |
| Pacific Rim Urology | Urology | Past | Accepting new patients |
Locations
269 S Candy Ln
Cottonwood, AZ 86326
Phone (928) 634-2251
1215 N Beaver St
Ste 203
Flagstaff, AZ 86001
Phone (928) 773-2249
Organizations & group practices 7
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.
-
- Gastroenterology Physician
- York, PA
- NPI 1669770004
-
- Multi-Specialty Clinic/Center
- Flagstaff, AZ
- NPI 1235732702
-
- Family Medicine Physician
- Flagstaff, AZ
- NPI 1669914552
Urology
-
- Oral & Maxillofacial Surgery (D.M.D.)
- Bellingham, WA
- NPI 1902971351
-
- Ambulatory Surgical Clinic/Center
- Bellingham, WA
- NPI 1952852873
-
- Urology Physician
- Bellingham, WA
- NPI 1295883700
-
- Clinic/Center
- Bellingham, WA
- NPI 1043384506
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Cottonwood, AZ
- NPI 1346291648
-
- General Acute Care Hospital
- Sedona, AZ
- NPI 1538608716
-
- General Acute Care Hospital
- York, PA
- NPI 1326060492
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776211200000",
"number": "1407937253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "340 BIRCHWOOD AVE",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982251782",
"telephone_number": "360-671-9197",
"fax_number": "360-676-7730"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "340 BIRCHWOOD AVE",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982251782",
"telephone_number": "360-671-9197",
"fax_number": "360-676-7730"
}
],
"practiceLocations": [
{
"address_1": "269 S Candy Ln",
"address_purpose": "LOCATION",
"city": "Cottonwood",
"state": "AZ",
"postal_code": "863264158",
"country_code": "US",
"telephone_number": "928-649-7970",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "25 Monument Rd Ste 190",
"address_purpose": "LOCATION",
"city": "York",
"state": "PA",
"postal_code": "174035059",
"country_code": "US",
"telephone_number": "717-741-8011",
"fax_number": "717-255-0966",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PETTIT",
"first_name": "JOHN",
"middle_name": "MARK",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-18",
"last_updated": "2026-04-15",
"certification_date": "2026-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "WA",
"license": "MD00024911",
"primary": true
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "PA",
"license": "MD494768",
"primary": false
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "AZ",
"license": "78751",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1032978",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bellingham, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2026; 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.