Mark Fetter, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

24439 Issued in AZ

Practice address

1615 Petroglyph Point Dr
Prescott, AZ 86301-6539

Phone

(928) 777-0200

Fax

(928) 443-1117

NPI assigned

Apr 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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 1

Specialty

Plastic and Reconstructive Surgery

Education

Wright State University Boonshoft School of Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Yavapai Regional Medical Center Hospital, Prescott, AZ, CCN 030012

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: advancedplasticsurgerycenter.markfetter@142412.advancedmd-direct.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mark D Fetter MD PC

  • Orthopaedic Hand Surgery Physician
  • Prescott, AZ
  • NPI 1124107206
  Medicare reassignment NPD Authorized official
• John B Giedraitis MD PC

  • Surgery Physician
  • Paradise Valley, AZ
  • NPI 1356436224
  NPD (past)
• Larry F Pass MD PC

  • Gastroenterology Physician
  • Scottsdale, AZ
  • NPI 1194736835
  NPD (past)

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

• Yavapai Community Hospital Association

  • General Acute Care Hospital
  • Prescott, AZ
  • NPI 1902897820
  Care Compare affiliation

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544400000000",
    "number": "1568427490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 PETROGLYPH POINT DR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863016539",
            "telephone_number": "928-777-0200",
            "fax_number": "928-443-1117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 PETROGLYPH POINT DR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863016539",
            "telephone_number": "928-777-0200",
            "fax_number": "928-443-1117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETTER",
        "first_name": "MARK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2018-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AZ",
            "license": "24439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna C Fernandez, RN
• Luis Anthony Fernandez, M.D.
• David Dale Fero, PH.D.
• Jaime Gayle Fesuk
• Karin Anne Fetter, R.N.
• Danielle Fetting, PA
• Elizabeth Fidler
• Robert Wendell Fields III, LMSW
• Fikes Orthopedic Specialties, Inc.
• Kenneth Paul Finn, M.D.

• Specialist in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Specialist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.