Mark T Selecky, M.D.

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

G78136 Issued in CA

Practice address

955 Lane Ave
Suite 200
Chula Vista, CA 91914-3501

Phone

(619) 421-3400

Fax

(619) 421-3557

NPI assigned

Jun 12, 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 CA

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

Sports MedicineAlso: Orthopedic Surgery

Education

Perelman School of Med at the University of Pennsylvania, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Synergy Orthopedic Specialists IncGroup PAC ID 0941450498, 66 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

99

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Synergy Orthopedic Specialists, Inc.

  • Specialist
  • San Diego, CA
  • NPI 1114282779
  Medicare reassignment Care Compare group NPD
• Emergency and Acute Care Medical Corporation

  • Emergency Medicine Physician
  • San Diego, CA
  • NPI 1437103942
  Medicare reassignment NPD
• Synergy Orthopedic Specialists, Inc.

  • Specialist
  • Temecula, CA
  • NPI 1194447888
  NPD
• Scripps Health

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1659359446
  NPD (past)
• Sharp Chula Vista Medical Center

  • Skilled Nursing Facility
  • Chula Vista, CA
  • NPI 1538142369
  NPD (past)
• Sharp Memorial Hospital

  • Rehabilitation Hospital Unit
  • San Diego, CA
  • NPI 1114901352
  NPD (past)

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1669414850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 LANE AVE",
            "address_2": "SUITE 200",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919143501",
            "telephone_number": "619-421-3400",
            "fax_number": "619-421-3557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 LANE AVE",
            "address_2": "SUITE 200",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919143501",
            "telephone_number": "619-421-3400",
            "fax_number": "619-421-3557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELECKY",
        "first_name": "MARK",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "CA",
            "license": "G78136",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G781360",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nina J. Segal, LCSW
• Isaura Macarena Segner
• Vesna Segos
• Yesenia Segovia
• Melanie Field Segui, APCC
• Select Cal Physical Therapy PC
• Select San Diego Physical Therapy, PC.
• Ryan Sendow
• Ae Annye Senethachith, RN
• Cydryx Sengco

• Sports Medicine (Orthopaedic Surgery) Physician in Chula Vista, CA
• Providers in Chula Vista, CA by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; 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.