Mark L Mudano, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

309292 Issued in NY

Practice address

75 Beekman St
Plattsburgh, NY 12901-1438

Phone

(518) 561-2000

NPI assigned

Sep 13, 2006

Last updated

Oct 19, 2022By 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 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC, GA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Musc Community Physicians

  dba MUSC Community Physicians Specialty

  • Internal Medicine Physician
  • Bamberg, SC
  • NPI 1841878006

  Orthopaedic Surgery

  Medicare reassignment NPD
• Phoebe Physician Group, Inc

  • Clinic/Center
  • Albany, GA
  • NPI 1487899464
  Medicare reassignment NPD
• Southern Regional Physicians Management Group, LLC

  • Surgery Physician
  • Riverdale, GA
  • NPI 1043677271
  Medicare reassignment NPD
• Theoria Medical

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1609362375

  GA

  Medicare reassignment NPD
• Musc Community Physicians

  dba MUSC Health Primary Care - Bowman

  • Rural Health Clinic/Center
  • Bowman, SC
  • NPI 1225735772
  NPD
• Musc Community Physicians

  dba MUSC Community Physicians PC

  • Family Medicine Physician
  • Bamberg, SC
  • NPI 1992383145
  NPD
• Chattahoochee Valley Bone & Joint, Inc.

  • Orthopaedic Surgery Physician
  • Columbus, GA
  • NPI 1043348071
  NPD (past)
• Surgeoncare Physicians of Georgia, LLC

  • Surgery Physician
  • Commerce, GA
  • NPI 1720228216
  NPD (past)

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666137600000",
    "number": "1487759650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 BEEKMAN ST",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129011438",
            "telephone_number": "518-561-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 BEEKMAN ST",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129011438",
            "telephone_number": "518-561-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Medical Dr Ste 707",
            "address_purpose": "LOCATION",
            "city": "LaGrange",
            "state": "GA",
            "postal_code": "302404130",
            "country_code": "US",
            "telephone_number": "706-880-7320",
            "fax_number": "706-812-2640",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11 UPPER RIVERDALE RD SW",
            "address_purpose": "LOCATION",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742615",
            "country_code": "US",
            "telephone_number": "770-897-7033",
            "fax_number": "770-996-3941",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "599 3rd Ave",
            "address_purpose": "LOCATION",
            "city": "West Point",
            "state": "GA",
            "postal_code": "318331523",
            "country_code": "US",
            "telephone_number": "706-242-5081",
            "fax_number": "770-999-2887",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUDANO",
        "first_name": "MARK",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "ME132909",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "GA",
            "license": "28054",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "309292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000802722E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephen William Morrison, RN
• Arelene Morrissey, LMHC
• Joshua John Morrow, LMHC
• Rebecca Morrow
• Mountain View Pediatrics PLLC
• Lina Tamara Muhtadie, M.D.
• Jonathan Gregory Mulholland, DC
• Nat Mulkey, MD
• Sara Munson, RPH
• Wendy Elizabeth Murnane, RN

• Orthopaedic Surgery Physician in Plattsburgh, NY
• Providers in Plattsburgh, NY by specialty
• Orthopaedic Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2022; 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.

Verify at the official NPI Registry.