Mark Seby MD PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

AZ11476 Issued in AZ

Legal business name

MARK SEBY MD PC

Doing business as

Agassiz Family Medicine

Practice address

417 N Agassiz St
BLDG #1
Flagstaff, AZ 86001-3282

Phone

(928) 779-6169

Fax

(928) 779-4200

NPI assigned

Apr 11, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Mark Vincent Seby, M.D.NPI 1649277492

Title

Physician

Phone

(928) 779-6169

Specialties & licenses 1

Addresses

Other identifiers 9

Other names 1

• AGASSIZ FAMILY MEDICINE Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark V Seby, M.D.

  • Family Medicine Physician
  • Flagstaff, AZ
  • NPI 1649277492
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1207872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293667200000",
    "number": "1477726222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 N AGASSIZ ST",
            "address_2": "BLDG #1",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013282",
            "telephone_number": "928-779-6169",
            "fax_number": "928-779-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 N AGASSIZ ST",
            "address_2": "BLDG #1",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013282",
            "telephone_number": "928-779-6169",
            "fax_number": "928-779-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK SEBY MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-11",
        "last_updated": "2010-12-30",
        "status": "A",
        "authorized_official_last_name": "SEBY",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "VINCENT",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "928-779-6169",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "AZ11476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080008588",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5447372",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "87726",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3323257",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET AZ",
            "identifier": "1Z8845",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "188857300",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "23957601",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MUTUAL OF OMAHA",
            "identifier": "71412",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD AZ",
            "identifier": "AZ0021730",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AGASSIZ FAMILY MEDICINE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christopher Johann Margeson, PH.D.
• Karoline S. Mariano, RN,MSN
• Kailee Marikar
• Mark E. Donnelly MD PC
• Mark Miller, MD, PC
• Edward Markman, D.O.
• Susan Marks, BCBA
• Peggy Marlatt, LPN, RVT
• Juanita Louise Marlette, RD
• Karina Marquez, SLPA

• Family Medicine Physician in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.