Mark S Penner, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

20A8037 Issued in CA

Practice address

2105 Forest Ave
San Jose, CA 95128-1425

Phone

(408) 947-2500

Fax

(818) 587-2493

NPI assigned

Jun 29, 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 3

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

Emergency Medicine

Education

Western University of Health Sciences College of Dental Med, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Physicians Associates San Jose PCGroup PAC ID 8921344292, 131 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Santa Clara Valley Medical Center Hospital, San Jose, CA, CCN 050038

Merit-based Incentive Payment System (MIPS)

Final score

61 of 100Reported as group

Quality

59.41

Promoting interoperability

0

Improvement activities

40

Cost

71.45

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mpenner125209@santaclaravalley.direct-ci.net

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.

• Emergency Physicians Associates San Jose PC

  • Emergency Medicine Physician
  • San Jose, CA
  • NPI 1306311576
  Medicare reassignment Care Compare group NPD
• County of Santa Clara

  dba Josefina Narvaez Mental Health Center MH Aoa

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Jose, CA
  • NPI 1699885079
  Medicare reassignment NPD
• Emergency Physicians Associates Fremont PC

  • Emergency Medicine Physician
  • Fremont, CA
  • NPI 1790250967
  Medicare reassignment NPD
• County of Santa Clara

  dba SCVMC Physician Services

  • Anesthesiology Physician
  • San Jose, CA
  • NPI 1588721500

  Emergency Medicine

  NPD
• County of Santa Clara

  dba SCVMC Outpatient Pharmacy

  • Pharmacy
  • San Jose, CA
  • NPI 1891871919
  NPD
• Emergency Physicians Associates Overhead Operating Account Dennis Belo

  dba Emergency Physician Associates

  • Emergency Medicine Physician
  • San Jose, CA
  • NPI 1013969153
  NPD
• Carbon Health Primary Care of California PC

  • Multi-Specialty Clinic/Center
  • Berkeley, CA
  • NPI 1972057990
  NPD (past)
• Waterbury Hospital

  • General Acute Care Hospital
  • Waterbury, CT
  • NPI 1184615114
  NPD (past)

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

• County of Santa Clara

  dba Inpatient Acute/Outpatient Facility Services

  • General Acute Care Hospital
  • San Jose, CA
  • NPI 1063406551
  Care Compare affiliation

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689602500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4419",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913654419",
            "telephone_number": "888-620-3100",
            "fax_number": "818-587-2493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 FOREST AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281425",
            "telephone_number": "408-947-2500",
            "fax_number": "818-587-2493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNER",
        "first_name": "MARK",
        "middle_name": "S",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A8037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX80370",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00273019",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "020A80370",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mei Yu Peng, L.AC.
• Yan Peng
• Janine Elizabeth Penha, RD, CDE
• Patricia Ann Penn, PHD
• Jilli Penner
• Samantha Ann Penney
• Hannah Jane Pennington
• Kaleigh Pennington
• Roman Pennix
• Augustus Pennock

• Emergency Medicine Physician in San Jose, CA
• Providers in San Jose, CA by specialty
• Emergency Medicine Physician in California

• 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.