Individual provider Active NPI

Mark Andrew Valasek, MD PHD

  • Anatomic Pathology & Clinical Pathology Physician
  • Bryan, TX
National Provider Identifier
1588808448
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
A127165 Issued in CA
Practice address
3201 University Dr E Ste 330
Bryan, TX 77802-3484
Phone
(979) 321-6290
Fax
(979) 774-1253
NPI assigned
Apr 22, 2009
Last updated
Nov 3, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X A127165 CA Primary

Addresses

Primary practice location

3201 University Dr E Ste 330
Bryan, TX 77802-3484

Mailing address

5700 Southwyck Blvd
Toledo, OH 43614-1509
Phone (800) 288-8325

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CA2 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

Enrollment IDStateProvider typePAC IDDetails
I20120726000101 TX Practitioner - Pathology 6608032289 Reassigns benefits to 1 organization
I20140422002335 CA Practitioner - PathologyPractitioner - Pulmonary Disease 6608032289 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2009
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3201 University Dr E
Suite 300
Bryan, TX 77802-3475
Phone (979) 321-6290

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A127165CAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pathology Institute PLLC Anatomic Pathology & Clinical Pathology CurrentSince Nov 6, 2021 Accepting new patients
Regents of the University of California CurrentSince Jan 11, 2014 Accepting new patients
Regents of the University of California Current Accepting new patients
Regents of the University of California Anatomic Pathology & Clinical Pathology CurrentSince Jan 11, 2014 Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients

Locations

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

5700 Southwyck Blvd
Toledo, OH 43614

3201 University Dr E
Ste 300
Bryan, TX 77802
Phone (979) 321-6290

3201 University Dr E
Ste 330
Bryan, TX 77802
Phone (979) 321-6290

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1240358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1588808448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 SOUTHWYCK BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436141509",
            "telephone_number": "800-288-8325",
            "fax_number": "419-866-5453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 UNIVERSITY DR E STE 330",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778023484",
            "telephone_number": "979-321-6290",
            "fax_number": "979-774-1253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALASEK",
        "first_name": "MARK",
        "middle_name": "ANDREW",
        "credential": "MD PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-22",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A127165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

Verify at the official NPI Registry.