Mark D Kriskovich, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

MD036079 Issued in TN

Practice address

100 W 4TH St
Suite 200
Cookeville, TN 38501-2448

Phone

(931) 528-1575

Fax

(931) 526-2962

NPI assigned

Aug 30, 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

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

Otolaryngology

Education

Baylor College of Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Upper Cumberland Otolaryngology Clinic, PCGroup PAC ID 1850487158, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cookeville Regional Medical Center Hospital, Cookeville, TN, CCN 440059
• Cumberland Medical Center Hospital, Crossville, TN, CCN 440009

Merit-based Incentive Payment System (MIPS)

Final score

95.83 of 100Reported as individual

Quality

91.67

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CJCECD

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.

• Upper Cumberland Otolaryngology Clinic, PC

  • Specialist
  • Cookeville, TN
  • NPI 1598821464
  Medicare reassignment Care Compare group NPD
• The Cookeville Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Cookeville, TN
  • NPI 1831283860
  NPD

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

• Cookeville Regional Medical Center

  • General Acute Care Hospital
  • Cookeville, TN
  • NPI 1275531956
  Care Compare affiliation
• Cumberland Medical Center, Inc.

  • General Acute Care Hospital
  • Crossville, TN
  • NPI 1871596403
  Care Compare affiliation

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619086626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W 4TH ST",
            "address_2": "SUITE 200",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385012448",
            "telephone_number": "931-528-1575",
            "fax_number": "931-526-2962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W 4TH ST",
            "address_2": "SUITE 200",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385012448",
            "telephone_number": "931-528-1575",
            "fax_number": "931-526-2962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRISKOVICH",
        "first_name": "MARK",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TN",
            "license": "MD036079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3872688",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Supriya Kohli, M.D.
• Rebecca Rae Kojak, DNP, RN
• Hima B Kona, MD
• Anne Kosgei
• Trina Nadia Kreil, D.C.
• Kroger Limited Partnership I
• Mollie Mariana Kvalvik, FMNP
• La Management Company
• States Labrum, OD
• Lillian Brady Laduke, RN

• Specialist in Cookeville, TN
• Providers in Cookeville, TN by specialty
• Specialist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.