Active NPI
Mark Fender, M.D.
- Anesthesiology Physician
- Sault Sainte Marie, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 4301065200
- Practice address
- 500 Osborn Blvd
Sault Sainte Marie, MI 49783-1822 - Phone
- (906) 635-4390
- NPI assigned
- May 24, 2006
- Last updated
- Jan 24, 2024
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 4301065200 | MI | |
| Anesthesiology Physician | 207L00000X | 4301065200 | MI | Primary |
Addresses
Primary practice location
500 Osborn Blvd
Sault Sainte Marie, MI 49783-1822
Mailing address
744 W Michigan Ave
Jackson, MI 49201-1909
Phone (517) 787-6440
Other practice location 1
419 S Coral St
Kalkaska, MI 49646-2503
Phone (231) 258-7777
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301065200 | MI | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kalkaska Memorial Health Center | Current | Accepting new patients | |
| Kalkaska Memorial Health Center | Current | Accepting new patients | |
| Munson Medical Group | Current | Accepting new patients | |
| Munson Medical Group | Current | Accepting new patients | |
| Munson Medical Center | Anesthesiology | Current | Accepting new patients |
| Munson Medical Group | Current | Accepting new patients | |
| Munson Medical Center | Current | Accepting new patients | |
| Macatawa Anesthesia PC | Anesthesiology | Current | Accepting new patients |
Locations
602 Michigan Ave
Holland, MI 49423
Phone (616) 394-3350
419 S Coral St
Kalkaska, MI 49646
Phone (231) 258-7500
1105 Sixth St
Ste 103
Traverse City, MI 49684
Phone (231) 935-6455
1200 Sixth St
Ste 200
Traverse City, MI 49684
4100 Park Forest Dr
Traverse City, MI 49684
Phone (231) 392-8900
Organizations & group practices 8
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Kalkaska, MI
- NPI 1013183060
-
- Anesthesiology Physician
- Holland, MI
- NPI 1942242136
-
- Skilled Nursing Facility
- Kalkaska, MI
- NPI 1164386652
-
- Anesthesiology Physician
- Traverse City, MI
- NPI 1710735287
-
- Psychiatric Hospital Unit
- Traverse City, MI
- NPI 1891586103
-
dba MHC Cedarwoods Internal Medicine and Geriatrics
- Geriatric Medicine (Internal Medicine) Physician
- Traverse City, MI
- NPI 1326801440
-
dba Munson Partners In Health
- Family Medicine Physician
- Traverse City, MI
- NPI 1447859558
-
dba Traverse Heart and Vascular
- Cardiovascular Disease Physician
- Traverse City, MI
- NPI 1821398322
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706054400000",
"number": "1447205539",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "744 W MICHIGAN AVE",
"city": "JACKSON",
"state": "MI",
"postal_code": "492011909",
"telephone_number": "517-787-6440",
"fax_number": "517-787-4146"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 OSBORN BLVD",
"city": "SAULT SAINTE MARIE",
"state": "MI",
"postal_code": "497831822",
"telephone_number": "906-635-4390"
}
],
"practiceLocations": [
{
"address_1": "419 S Coral St",
"address_purpose": "LOCATION",
"city": "Kalkaska",
"state": "MI",
"postal_code": "496462503",
"country_code": "US",
"telephone_number": "231-258-7777",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FENDER",
"first_name": "MARK",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-24",
"last_updated": "2024-01-24",
"certification_date": "2024-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "MI",
"license": "4301065200",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "MI",
"license": "4301065200",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Sault Sainte Marie, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.