Individual provider Active NPI

Mark David Pell, DPM

  • Foot & Ankle Surgery Podiatrist
  • Union, KY
National Provider Identifier
1639433261
Registry record updated Oct 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
243972 Issued in KY
Practice address
605 Man O War Blvd
Union, KY 41091-2017
Phone
(859) 212-0175
Fax
(859) 384-0323
NPI assigned
Jun 28, 2012
Last updated
Oct 21, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X SC006335 PA
Foot & Ankle Surgery Podiatrist 213ES0103X 243972 KY Primary

Addresses

Primary practice location

605 Man O War Blvd
Union, KY 41091-2017

Mailing address

PO Box 635283
Cincinnati, OH 45263-5283
Phone (859) 212-0175

Other practice location 1

1500 James Simpson Jr Way
Covington, KY 41011-0801
Phone (859) 212-0175

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, KY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150825002812 PA Practitioner - Podiatry 5193031912 Reassigns benefits to 1 organization
I20200113000193 KY Practitioner - Podiatry 5193031912 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group IncGroup PAC ID 2163326240, 803 clinicians

Practice addresses (Care Compare)

1500 James Simpson Jr Way
Covington, KY 41011-0800
Phone (859) 655-4111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue43
Removal of skin lesions1-10
Removal of nail tissue466
Removal or shaving of skin growth30

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
243972KYMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc. Foot & Ankle Surgery CurrentSince Jan 31, 2020 Accepting new patients
Bryn Mawr Foot & Ankle Center, LLC CurrentSince Mar 7, 2016 Accepting new patients
Summit Medical Group, Inc Foot & Ankle Surgery CurrentSince Jan 31, 2020 Accepting new patients
Integrated Foot and Ankle Specialists of PA LLC Foot & Ankle Surgery PastSince Mar 7, 2016 Accepting new patients

Locations

1500 James Simpson Jr Way
Covington, KY 41011
Phone (859) 655-4353

405 Violet Rd
Crittenden, KY 41030
Phone (859) 428-1610

1980 Litton Ln
Hebron, KY 41048
Phone (859) 334-8700

200 W 3rd St
Newport, KY 41071
Phone (859) 212-0175

525 Alexandria Pike
Southgate, KY 41071
Phone (859) 212-0175

605 Man O War Blvd
Union, KY 41091
Phone (859) 578-5333

300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217

934 County Line Rd
Bryn Mawr, PA 19010
Phone (610) 527-3311

Interoperability endpoints

  • Direct secure messaging: mark.pell@brynmaw.ehi.direct-ci.com
  • Direct secure messaging: mpell298538@direct-prd.stelizabeth.com

Organizations & group practices 4

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 3

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": "1340841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792540800000",
    "number": "1639433261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635283",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635283",
            "telephone_number": "859-212-0175",
            "fax_number": "859-384-0323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 MAN O WAR BLVD",
            "city": "UNION",
            "state": "KY",
            "postal_code": "410912017",
            "telephone_number": "859-212-0175",
            "fax_number": "859-384-0323"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 James Simpson Jr Way",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "KY",
            "postal_code": "410110801",
            "country_code": "US",
            "telephone_number": "859-212-0175",
            "fax_number": "859-655-8911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PELL",
        "first_name": "MARK",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-28",
        "last_updated": "2026-10-21",
        "certification_date": "2026-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC006335",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "KY",
            "license": "243972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union, KY

Sources for this page

Verify at the official NPI Registry.