Individual provider Active NPI

Mark A Sanders, PA-C

  • Medical Physician Assistant
  • Rock Springs, WY
National Provider Identifier
1619018918
Registry record updated Jan 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
177 Issued in WY
Practice address
3000 College Dr
Rock Springs, WY 82901-4202
Phone
(307) 212-7708
Fax
(307) 352-8148
NPI assigned
Feb 9, 2007
Last updated
Jan 23, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 177 WY Primary

Addresses

Primary practice location

3000 College Dr
Rock Springs, WY 82901-4202

Mailing address

PO Box 1359
Rock Springs, WY 82902-1359
Phone (307) 212-7708

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070328000140 WY Practitioner - Physician Assistant 7113021312 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1200 College Dr
Rock Springs, WY 82901-5868
Phone (307) 362-3711

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.04 of 100Reported as group
Quality
64.43
Promoting interoperability
100
Improvement activities
40
Cost
72.37

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
177WYMDPeer Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital of Sweetwater County Past Accepting new patients
Aspen Mountain Physician Practice Management LLC Past Accepting new patients

Organizations & group practices 3

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 4

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

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1619018918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1359",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829021359",
            "telephone_number": "307-212-7708",
            "fax_number": "307-352-8148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 COLLEGE DR",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829014202",
            "telephone_number": "307-212-7708",
            "fax_number": "307-352-8148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WY",
            "license": "177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Springs, WY

Sources for this page

Verify at the official NPI Registry.