Mark Bryniarski, MD
Individual provider Active NPI Neurological Surgery Physician · Albuquerque, NM
NPI 1528063161 · NPPES record last updated Aug 25, 2021
Key facts
- NPI
- 1528063161
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Neurological Surgery Physician 207T00000X
- License
- 97-21 (NM)
- Practice address
- 500 Walters St NE
Ste 401
Albuquerque, NM 87102-2563 - Phone
- (505) 727-5910
- Fax
- (505) 727-5939
- NPI assigned
- Jun 20, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Neurosurgery
- Education
- Other, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Southwest Medical Associates, LLC
Practice addresses (Care Compare)
500 Walter St NE
Suite 401
Albuquerque, NM 87102-2563
Phone (505) 727-5910
Hospital & facility affiliations
- Lovelace Medical Center
- Lovelace Women'S Hospital
- Lovelace Westside Hospital
- Lovelace Unm Rehabilitation Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Spinal fusion | 21 |
| Laminectomy or laminotomy (partial removal of spine bones) | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160316002530 | NM | Practitioner - Neurosurgery | 6608818646 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 62063 | AZ | MD | Neurological Surgery Physician |
| 97-21 | NM | MD | Neurological Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Presbyterian Healthcare Services | Neurological Surgery | Current |
Accepting new patients |
| Lovelace Health System, LLC | Current |
Accepting new patients | |
| Presbyterian Healthcare Services | Current |
Accepting new patients | |
| Lovelace Health System, LLC | Current |
Accepting new patients | |
| Lovelace Health System LLC | Current | Accepting new patients | |
| Healthone Clinic Services Neurosciences LLC | Neurological Surgery | Past | Accepting new patients |
| Lovelace Health System LLC | Past | Accepting new patients |
Locations
10501 Golf Course Rd NW
Albuquerque, NM 87114
Phone (505) 727-2000
201 Cedar St SE
Ste 5630
Albuquerque, NM 87106
Phone (505) 563-6399
6100 Pan American East Fwy NE
Albuquerque, NM 87109
Phone (505) 823-1010
4701 Montgomery Blvd NE
Albuquerque, NM 87109
Phone (505) 727-2000
4801 McMahon Blvd NW
Ste 110
Albuquerque, NM 87114
Phone (505) 727-4500
601 Martin Luther King Ave NE
Albuquerque, NM 87102
Phone (505) 727-8040
715 Martin Luther King Ave NE
Ste 301
Albuquerque, NM 87102
Phone (505) 727-4500
2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577
Interoperability endpoints
- mbryniarski100014@direct.phs.org
- mbryniarski7041@ahs.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | 62063 | AZ | |
| Neurological Surgery Physician | 207T00000X | 97-21 | NM | Yes |
Addresses
Primary practice location
500 Walters St NE
Ste 401
Albuquerque, NM 87102-2563
Mailing address
201 Cedar St SE
Ste 5630
Albuquerque, NM 87106-4920
Phone (505) 727-5910
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 28919826 | Other | CO | MEDICAID GROUP NUMBER |
| DG3723 | Other | CO | RAILROAD MEDICARE GROUP NUMBER |
| 73926337 | Other | CO | MEDICAID PRACTICE NUMBER |
| 31901751 | Medicaid | CO | |
| 348308 | Other | CO | MEDICARE GROUP NUMBER |
| 97-21 | Other | NM | NM LICENSE |
| C810213 | Other | CO | MEDICARE GROUP NUMBER |
Other providers in Albuquerque, NM
- Patricia Lynn Bryant
- Shawn Kaelan Bryant
- Donna Denise Bryce
- Emily Jeanne Bryl
- Elizabeth Bryniarski
- Melissa Bryson
- Bubar and Counseling Associates LLC
- Rhoda W Bubar
- Amy L. Bubbico
- Corrie Lynn Bubbico
All providers in Albuquerque, NM · Neurological Surgery Physician in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 25, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.