Individual provider Active NPI

Mark Lieser, MD

  • Trauma Surgery Physician
  • Odessa, TX
National Provider Identifier
1699835504
Registry record updated Sep 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
License
K5142 Issued in TX
Practice address
540 W 5TH St
350
Odessa, TX 79761-5034
Phone
(432) 332-7500
Fax
(432) 332-7503
NPI assigned
Dec 11, 2006
Last updated
Sep 11, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Trauma Surgery Physician 2086S0127X K5142 TX Primary

Addresses

Primary practice location

540 W 5TH St
350
Odessa, TX 79761-5034

Mailing address

600 Toronto Ave Apt 18
McAllen, TX 78503-3071
Phone (956) 687-7151

Other identifiers 3

IdentifierTypeStateIssuer
118656105MedicaidTX
P00326685OtherTXRAILROAD
8S4850OtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20170411000465 MO Practitioner - General Surgery 8527054360 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Rutgers New Jersey Medical School, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urgent Specialty Associates of Missouri LLCGroup PAC ID 2860874831, 39 clinicians

Practice addresses (Care Compare)

2316 E Meyer Blvd
Kansas City, MO 64132-1136
Phone (816) 276-4000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Specialty Associates of Missouri LLC CurrentSince Aug 1, 2022 Accepting new patients
Midwest Division - RMC, LLC Past Accepting new patients
Urgent Specialty Associates of Missouri LLC PastSince Aug 14, 2022 Accepting new patients

Locations

2316 E Meyer Blvd
Kansas City, MO 64132
Phone (816) 276-4360

Organizations & group practices 3

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 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": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378857600000",
    "number": "1699835504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 TORONTO AVE APT 18",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785033071",
            "telephone_number": "956-687-7151",
            "fax_number": "956-668-8346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 W 5TH ST",
            "address_2": "350",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797615034",
            "telephone_number": "432-332-7500",
            "fax_number": "432-332-7503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIESER",
        "first_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2013-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "TX",
            "license": "K5142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118656105",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P00326685",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8S4850",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

Verify at the official NPI Registry.