Mark P. Ombrellaro, MD

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

MD00033502 Issued in WA

Practice address

1135 116TH Ave NE Ste 220
Bellevue, WA 98004-4623

Phone

(425) 450-7007

Fax

(425) 450-0026

NPI assigned

Jul 17, 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 WA, AK2 enrollments

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 2

Specialty

Vascular Surgery

Education

University of Washington School of Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fairbanks Memorial Cardiology Center LLCGroup PAC ID 0244511269, 25 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fairbanks Memorial Hospital Hospital, Fairbanks, AK, CCN 020012

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mark.ombrellaro.p1@direct.porterheart.nextgenshare.com

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.

• Fairbanks Memorial Cardiology Center, LLC

  • Multi-Specialty Clinic/Center
  • Fairbanks, AK
  • NPI 1386193472
  Medicare reassignment Care Compare group NPD
• King County Public Hospital District No 2

  • Neuromusculoskeletal Medicine & OMM Physician
  • Kirkland, WA
  • NPI 1801986070
  Medicare reassignment NPD
• King County Public Hospital District No 2

  • Internal Medicine Physician
  • Kirkland, WA
  • NPI 1467542639
  NPD
• King County Public Hospital District No. 2

  • Physical Therapist
  • Kirkland, WA
  • NPI 1356920946
  NPD
• Eastside Vascular LLP

  • Vascular Surgery Physician
  • Bellevue, WA
  • NPI 1356471833
  NPD (past)
• Fairbanks Memorial Hospital, LLC

  • General Acute Care Hospital
  • Fairbanks, AK
  • NPI 1720537178
  NPD (past)

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

• Fairbanks Memorial Hospital, LLC

  • General Acute Care Hospital
  • Fairbanks, AK
  • NPI 1720537178
  Care Compare affiliation

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699793968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 116TH AVE NE STE 220",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044623",
            "telephone_number": "425-450-7007",
            "fax_number": "425-450-0026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 116TH AVE NE STE 220",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044623",
            "telephone_number": "425-450-7007",
            "fax_number": "425-450-0026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMBRELLARO",
        "first_name": "MARK",
        "middle_name": "P.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "WA",
            "license": "MD00033502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1098326",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Olympic Ocd Services PLLC
• Olympic Physical Therapy of Bellevue Inc.
• Olympic Physical Therapy, Inc
• Janet C Omaits, LICSW
• John Omalley, MA,LMHC,CDP,CCFC
• Omni Massage LLC
• On Good Hands Afh LLC
• Oncken Chiropractic Clinic LLC
• Joshua C. Oncken, D.C.
• Oncology Rehabilitation Specialists, Inc.

• Vascular Surgery Physician in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Vascular Surgery Physician in Washington

• 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.