NPIMap

Individual provider Active NPI

Mark Brendan Reedy X, MD

  • Gynecologic Oncology Physician
  • Lubbock, TX
National Provider Identifier
1487659876
Registry record updated Mar 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
H8348 Issued in TX
Practice address
602 Indiana Ave
Lubbock, TX 79415-3364
Phone
(806) 775-8600
Fax
(806) 775-8586
NPI assigned
Jun 14, 2005
Last updated
Mar 16, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecologic Oncology Physician 207VX0201X H8348 TX Primary

Addresses

Primary practice location

602 Indiana Ave
Lubbock, TX 79415-3364

Mailing address

6107 88TH PL
Lubbock, TX 79424-0839
Phone (325) 665-0118

Other practice location 1

2821 Michaelangelo Dr Ste 202
Edinburg, TX 78539-1406
Phone (956) 362-2465

Other identifiers 4

IdentifierTypeStateIssuer
122327308MedicaidTX
H08KE62101OtherTXBCBS
122327306MedicaidTX
122327315MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mark.reedy@direct.myteamcare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050217000295 TX Practitioner - Gynecological OncologyPractitioner - Obstetrics/GynecologyPractitioner - Hospice/Palliative CarePractitioner - Plastic and Reconstructive SurgeryPractitioner - UrologyPractitioner - Critical Care (Intensivists)Practitioner - Surgical OncologyPractitioner - Medical Genetics and Genomics 8325090442 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gynecological OncologyAlso: Critical Care (Intensivists), Hospice/Palliative Care, Medical Genetics and Genomics, Obstetrics/Gynecology
Education
Texas Tech University Health Science Center School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

602 Indiana Ave
Lubbock, TX 79415-3364
Phone (806) 743-7337

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.52 of 100Reported as apm
Quality
87.98
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Skin biopsy1-10
Removal of the uterus1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Aug 1, 2019 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Current Accepting new patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Aug 1, 2019 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Past Accepting new patients
University of Texas Rio Grande Valley Past Accepting new patients

Locations

2412 50th St
Lubbock, TX 79412
Phone (806) 788-4000

3601 4th St
Lubbock, TX 79430
Phone (806) 743-1000

4515 Marsha Sharp Fwy
Lubbock, TX 79407
Phone 80674472232432

602 Indiana Ave
Lubbock, TX 79415
Phone (806) 743-2898

Interoperability endpoints

  • Direct secure messaging: mark.reedy@direct.myteamcare.com
  • Direct secure messaging: mreedy@yourcarecommunity.org

Organizations & group practices 5

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615852800000",
    "number": "1487659876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6107 88TH PL",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794240839",
            "telephone_number": "325-665-0118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 INDIANA AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794153364",
            "telephone_number": "806-775-8600",
            "fax_number": "806-775-8586"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2821 Michaelangelo Dr Ste 202",
            "address_purpose": "LOCATION",
            "city": "Edinburg",
            "state": "TX",
            "postal_code": "785391406",
            "country_code": "US",
            "telephone_number": "956-362-2465",
            "fax_number": "956-362-2466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REEDY",
        "first_name": "MARK",
        "middle_name": "BRENDAN",
        "name_prefix": "Dr.",
        "name_suffix": "X",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-14",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "TX",
            "license": "H8348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122327308",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "H08KE62101",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122327306",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122327315",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mark.reedy@direct.myteamcare.com",
            "affiliation": "N",
            "address_1": "602 Indiana Ave",
            "city": "Lubbock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "794153364",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.