NPIMap

Individual provider Active NPI

Mark Ende, M.D.

  • Internal Medicine Physician
  • Petersburg, VA
National Provider Identifier
1528152824
Registry record updated Apr 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
BC83898 Issued in VA
Practice address
121 S Market St
Petersburg, VA 23803-4217
Phone
(804) 733-8771
Fax
(804) 733-1017
NPI assigned
Oct 3, 2006
Last updated
Apr 26, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2010

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 BC83898 VA Primary

Addresses

Primary practice location

121 S Market St
Petersburg, VA 23803-4217

Mailing address

121 S Market St
Petersburg, VA 23803-4217
Phone (804) 733-8771

Other identifiers 3

IdentifierTypeStateIssuer
005861837MedicaidVA
229767802OtherVATRICARE
251257OtherVAANTHEM BLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20111207000881 VA Practitioner - Internal Medicine 9739354432 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Eastern Virginia Medical School, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

121 S Market St
Petersburg, VA 23803-4217
Phone (804) 733-8771

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BC83898VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ende Medical Practice, LLP Internal Medicine CurrentSince Jul 1, 2001 Accepting new patients
Hemodialysis Assoc PC Internal Medicine Past Accepting new patients

Locations

121 S Market St
Petersburg, VA 23803
Phone (804) 733-8771

Organizations & group practices 2

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 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272240000000",
    "number": "1528152824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 S MARKET ST",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238034217",
            "telephone_number": "804-733-8771",
            "fax_number": "804-733-1017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 S MARKET ST",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238034217",
            "telephone_number": "804-733-8771",
            "fax_number": "804-733-1017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENDE",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2010-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "BC83898",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005861837",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "229767802",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "251257",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Petersburg, VA

Sources for this page

Verify at the official NPI Registry.