Mark P Menolascino, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

6730A Issued in WY

Practice address

5235 HHR Ranch Road
Wilson, WY 83014-0000

Phone

(307) 732-1039

NPI assigned

Aug 19, 2006

Last updated

Jun 17, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective May 20, 2014 through May 20, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Mark P Menolascino MD PC

  • Internal Medicine Physician
  • Wilson, WY
  • NPI 1972781524
  NPD (past) Authorized official

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466121600000",
    "number": "1467566117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4816",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830014816",
            "telephone_number": "307-732-1039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5235 HHR RANCH ROAD",
            "city": "WILSON",
            "state": "WY",
            "postal_code": "830140000",
            "telephone_number": "307-732-1039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENOLASCINO",
        "first_name": "MARK",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2016-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WY",
            "license": "6730A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118685000",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sally L Luke, FNP-C
• Richard Lundeen, CMHW
• Maurice Keith Mader, M.S.W., L.C.S.W.
• Mark Matthew Neimat, MD LLC
• Mark P Menolascino MD PC
• Michael James Menolascino, MD
• Michael Menolascino MD
• Peter Moffatt, LPC
• Oak Physical Therapy & Wellness PC
• Madison August Oak, DPT

• Internal Medicine Physician in Wilson, WY
• Providers in Wilson, WY by specialty
• Internal Medicine Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2016; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.