Mark Harry Lyda, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

MD60797389 Issued in WA

Practice address

13103 E Mansfield Avenue
Spokane Valley, WA 99216-1642

Phone

(509) 892-2700

Fax

(509) 892-2740

NPI assigned

Jul 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in TN, WA2 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

Specialty

Pathology

Education

Oregon Health Sciences University School of Medicine, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Incyte Pathology PLLCGroup PAC ID 9638067945, 43 clinicians

Washington Gastroenterology PLLCGroup PAC ID 6204194848, 142 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Incyte Pathology, PLLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Spokane Valley, WA
  • NPI 1326086745
  Medicare reassignment Care Compare group NPD
• Washington Gastroenterology PLLC

  • Gastroenterology Physician
  • Tacoma, WA
  • NPI 1306364401
  Medicare reassignment Care Compare group NPD
• Associated Pathologists, LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Nashville, TN
  • NPI 1003863580
  Medicare reassignment NPD
• Washington Gastroenterology PLLC

  • Clinical Medical Laboratory
  • Federal Way, WA
  • NPI 1245265826
  NPD
• Washington Gastroenterology PLLC

  • Clinical Medical Laboratory
  • Federal Way, WA
  • NPI 1467011122
  NPD
• Trumbull Laboratories, LLC

  • Clinical Medical Laboratory
  • Germantown, TN
  • NPI 1063449320
  NPD
• Associated Pathologists LLC

  • Clinical Medical Laboratory
  • Nashville, TN
  • NPI 1124075635
  NPD (past)

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676592000000",
    "number": "1588694459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3405",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992203405",
            "telephone_number": "509-892-2700",
            "fax_number": "509-892-2740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13103 E MANSFIELD AVENUE",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992161642",
            "telephone_number": "509-892-2700",
            "fax_number": "509-892-2740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYDA",
        "first_name": "MARK",
        "middle_name": "HARRY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TN",
            "license": "31836",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "WA",
            "license": "MD60797389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3135931",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000000013333",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139243001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "98771",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2098536",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0121289",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "3135931",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3843923",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sheena Lukens
• Holly Lynn Lundberg
• Ashley Rae Lundell, RN
• Melissa Lerai Lunsford, LMT
• Luxottica of America Inc.
• Mitchell Lee Lykins, SUDP
• Trisha Anne Lykins, CDP
• Andrea Lyman, MA, LBA, BCBA
• Sheila Diane Lynam, MD
• Andrea Lynch, PHARMD

• Anatomic Pathology & Clinical Pathology Physician in Spokane Valley, WA
• Providers in Spokane Valley, WA by specialty
• Anatomic Pathology & Clinical Pathology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2023; 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.