Organization Active NPI

Mark M Scheurer MD PC

  • Otolaryngology Physician
  • Coronado, CA
National Provider Identifier
1508385741
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
MARK M SCHEURER MD PC
Practice address
1222 1St St
Coronado, CA 92118-1491
Phone
(619) 787-7406
Fax
(619) 359-8762
NPI assigned
Sep 19, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mark M Scheurer, MDNPI 1942250089
Title
President
Phone
(619) 787-7406

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X Primary

Addresses

Primary practice location

1222 1St St
Coronado, CA 92118-1491

Mailing address

1222 1St St
3
Coronado, CA 92118
Phone (619) 787-7406

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171208002152 CA Part B Supplier - Clinic/Group Practice 3072870559 Receives reassigned benefits from 1 practitioner
Practice locations: Coronado, CA

National Provider Directory

National Provider Directory

Locations

1222 1st St
Ste 3
Coronado, CA 92118
Phone (520) 722-5477

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1505779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1508385741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1222 1ST ST",
            "address_2": "3",
            "city": "CORONADO",
            "state": "CA",
            "postal_code": "92118",
            "telephone_number": "619-787-7406",
            "fax_number": "619-359-8762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 1ST ST",
            "city": "CORONADO",
            "state": "CA",
            "postal_code": "921181491",
            "telephone_number": "619-787-7406",
            "fax_number": "619-359-8762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK M SCHEURER MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-19",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SCHEURER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-787-7406",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coronado, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.