Individual provider Active NPI

Mark L Harrison, MD

  • Radiation Oncology Physician
  • McAllen, TX
National Provider Identifier
1417954124
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
G4598 Issued in TX
Practice address
620 S Broadway St
McAllen, TX 78501-4906
Phone
(956) 682-9680
Fax
(956) 682-9915
NPI assigned
Jul 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X G4598 TX Primary

Addresses

Primary practice location

620 S Broadway St
McAllen, TX 78501-4906

Mailing address

620 S Broadway St
McAllen, TX 78501-4906
Phone (956) 682-9680

Other identifiers 1

IdentifierTypeStateIssuer
96320902MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20040130000394 TX Practitioner - Radiation Oncology 2961305545 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
University of Cincinnati College of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Cancer Associates PAGroup PAC ID 4082790126, 3 clinicians

Practice addresses (Care Compare)

1719 Treasure Hills Blvd
Harlingen, TX 78550-8912

1719 Treasure Hills Blvd
Harlingen, TX 78550-8949
Phone (956) 364-2131

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G4598TXMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Cancer Associates PA Radiation Oncology CurrentSince Jan 18, 2008 Accepting new patients
Valley Cancer Associates PA CurrentSince Jan 18, 2008 Accepting new patients
Urology Associates of South Texas PA Past Accepting new patients
Radiation Medicine Associates Radiation Oncology PastSince Jan 1, 2000 Accepting new patients
Urorad Healthcare LP Past Accepting new patients

Locations

844 Central Blvd
Ste 430
Brownsville, TX 78520
Phone (956) 544-7833

1719 Treasure Hills Blvd
Harlingen, TX 78550
Phone (956) 212-4388

Organizations & group practices 5

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": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417954124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 S BROADWAY ST",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785014906",
            "telephone_number": "956-682-9680",
            "fax_number": "956-682-9915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 S BROADWAY ST",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785014906",
            "telephone_number": "956-682-9680",
            "fax_number": "956-682-9915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "MARK",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "TX",
            "license": "G4598",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "96320902",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McAllen, TX

Sources for this page

Verify at the official NPI Registry.