Individual provider Active NPI

Mark Lewis Nelson, MD

  • Ophthalmology Physician
  • Tacoma, WA
National Provider Identifier
1689647109
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
00043072 Issued in WA
Practice address
2245 S 19TH St
200
Tacoma, WA 98405-2945
Phone
(253) 572-1444
Fax
(253) 830-2528
NPI assigned
Feb 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 00043072 WA Primary

Addresses

Primary practice location

2245 S 19TH St
200
Tacoma, WA 98405-2945

Mailing address

2245 S 19TH St
200
Tacoma, WA 98405-2945
Phone (253) 572-1444

Other identifiers 1

IdentifierTypeStateIssuer
G8895607OtherWAPTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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

Enrollment IDStateProvider typePAC IDDetails
I20090326000513 WA Practitioner - OphthalmologyPractitioner - Other (Physician) 6507923026 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Uniformed Services Uhs Fe Hebert School of Med, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sound Retina PSGroup PAC ID 5193911170, 6 clinicians

Practice addresses (Care Compare)

2245 S 19TH St
Suite 200
Tacoma, WA 98405-2945
Phone (253) 572-1444

Hospital & facility affiliations

  • Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129

Merit-based Incentive Payment System (MIPS)

Final score
99.93 of 100Reported as group
Quality
99.85
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
00043072WAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Retina PS CurrentSince Aug 9, 2010 Accepting new patients
Retina & Macula Specialists PS Ophthalmology Past Accepting new patients
Retina and Macula Specialists PS Ophthalmology Past Accepting new patients
Retina and Macula Specialists PS Ophthalmology Past Accepting new patients

Locations

7516 W Deschutes Pl
Kennewick, WA 99336
Phone (509) 596-0952

3773 Martin Way E
Ste C101
Olympia, WA 98506

3773 Martin Way E
Ste 101
Olympia, WA 98506

2245 S 19th St
Tacoma, WA 98405
Phone (253) 572-1444

2245 S 19th St
#200
Tacoma, WA 98405
Phone (253) 572-1444

Interoperability endpoints

  • Direct secure messaging: mnelson@soundretina.intellechartdirect.net

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1689647109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2245 S 19TH ST",
            "address_2": "200",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984052945",
            "telephone_number": "253-572-1444",
            "fax_number": "253-830-2528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2245 S 19TH ST",
            "address_2": "200",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984052945",
            "telephone_number": "253-572-1444",
            "fax_number": "253-830-2528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "MARK",
        "middle_name": "LEWIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WA",
            "license": "00043072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "G8895607",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.