Jennifer S Mark, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

203960 Issued in MA

Practice address

Athol Memorial Hospital
2033 Main Street
Athol, MA 01331

Phone

(978) 249-3511

NPI assigned

Jul 10, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Holyoke Medical Center, Inc.

  • General Acute Care Hospital
  • Holyoke, MA
  • NPI 1750395737

  Corporate Director

  CMS ownership

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.

• Baystate Affiliated Practice Organization

  • Internal Medicine Physician
  • Springfield, MA
  • NPI 1043256043

  Family Medicine

  NPD (past)
• Massachusetts Em-1 Medical Services

  • Physician Assistant
  • Holyoke, MA
  • NPI 1265620017
  NPD (past)
• The Mercy Hospital Inc

  dba Mercy Medical Center

  • General Acute Care Hospital
  • Springfield, MA
  • NPI 1043204316
  NPD (past)

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437183266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 WARD AVE",
            "city": "NORTHAMPTON",
            "state": "MA",
            "postal_code": "010602863",
            "telephone_number": "978-249-3511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ATHOL MEMORIAL HOSPITAL",
            "address_2": "2033 MAIN STREET",
            "city": "ATHOL",
            "state": "MA",
            "postal_code": "01331",
            "telephone_number": "978-249-3511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARK",
        "first_name": "JENNIFER",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "203960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keegan J Lutz
• Nicole Lyman, BS
• Mathew John Madonna, PSYA.D., LMHC
• Alexandra Mahan
• Heather M Mahoney, MASTERS
• Danielle Laurie Marshall, MA
• Janice Martin, RN
• Jeremy King Martin, MA
• Erica Carmen Masson, LICSW
• Laura Leigh Mastromatteo, M.A.

• Family Medicine Physician in Athol, MA
• Providers in Athol, MA by specialty
• Family Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.