Individual provider Active NPI

Mark D Schroeder, MD

  • Internal Medicine Physician
  • Winchester, VA
National Provider Identifier
1487615639
Registry record updated Jul 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101034244 Issued in VA
Practice address
104 Selma Dr
Winchester, VA 22601-3834
Phone
(540) 678-2800
NPI assigned
Mar 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101034244 VA Primary

Addresses

Primary practice location

104 Selma Dr
Winchester, VA 22601-3834

Mailing address

104 Selma Dr
Winchester, VA 22601-3834
Phone (540) 678-2800

Other identifiers 2

IdentifierTypeStateIssuer
298356OtherVAANTHEM BCBS
6024637MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20070808000651 VA Practitioner - Internal Medicine 7214950229 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101034244VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Winchester Medical Center CurrentSince May 26, 1995 Accepting new patients
Winchester Medical Center Current Accepting new patients
Winchester Medical Center CurrentSince May 26, 1995 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1840 Amherst St
Winchester, VA 22601
Phone (540) 536-8700

Organizations & group practices 4

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": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185321600000",
    "number": "1487615639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 SELMA DR",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226013834",
            "telephone_number": "540-678-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 SELMA DR",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226013834",
            "telephone_number": "540-678-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHROEDER",
        "first_name": "MARK",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2007-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101034244",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "298356",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6024637",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, VA

Sources for this page

Verify at the official NPI Registry.