Individual provider Active NPI

John Mark Pettit, MD

  • Urology Physician
  • Bellingham, WA
National Provider Identifier
1407937253
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD00024911 Issued in WA
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

Updated by the provider on Apr 15, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1032978MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070206000383 WA Practitioner - Urology 6709878887
I20260428002907 PA Practitioner - Urology 6709878887 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellspan Medical GroupGroup PAC ID 1951213115, 2,438 clinicians

Practice addresses (Care Compare)

25 Monument Rd
Suite 190
York, PA 17403-5059
Phone (717) 741-8011

Hospital & facility affiliations

  • Wellspan York Hospital Hospital, York, PA, CCN 390046
  • Verde Valley Medical Center Hospital, Cottonwood, AZ, CCN 030007

Merit-based Incentive Payment System (MIPS)

Final score
86.37 of 100Reported as individual
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

LicenseStateTypeSpecialty
78751AZMDUrology Physician
MD494768PAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Arizona Healthcare Corporation CurrentSince Dec 1, 2025 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.

Hospital & facility affiliations 6

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

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

Verify at the official NPI Registry.