Individual provider Active NPI

Lawrence A Mark, MD

  • Dermatology Physician
  • Indianapolis, IN
National Provider Identifier
1720025372
Registry record updated Dec 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
01062068 Issued in IN
Practice address
550 University Blvd
Uh 3240
Indianapolis, IN 46202-5149
Phone
(317) 274-7741
Fax
(317) 274-7051
NPI assigned
Jun 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 01062068 IN Primary

Addresses

Primary practice location

550 University Blvd
Uh 3240
Indianapolis, IN 46202-5149

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other identifiers 1

IdentifierTypeStateIssuer
200822500MedicaidIN

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address lmark3@direct.iuhealth.org
Direct Messaging Address lmark3@direct.iuhealth.org
Direct Messaging Address lmark13609@direct.eskenazihealth.edu Health Information Exchange (HIE) Eskenazi Health

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20060719000220 IN Practitioner - Dermatology 5597778423 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Indiana University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions285
Skin biopsy59

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01062068INMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iu Health Medical Group, LLC CurrentSince Oct 1, 2024 Accepting new patients
University Dermatology, Inc. Dermatology CurrentSince Jul 1, 2006 Accepting new patients
Major Hospital Past Accepting new patients

Locations

7593 Solutions Ctr
Chicago, IL 60677

1115 Ronald Reagan Pkwy
Ste 206
Avon, IN 46123
Phone (317) 217-2888

11590 N Meridian St
Ste 450
Carmel, IN 46032
Phone (317) 948-5926

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

550 University Blvd
Ste 3240
Indianapolis, IN 46202
Phone (317) 278-6833

720 Eskenazi Ave
Indianapolis, IN 46202
Phone (317) 880-0000

250 N Shadeland Ave
Ste 130
Indianapolis, IN 46219
Phone (317) 962-4836

720 Eskenazi Ave
#F2111
Indianapolis, IN 46202

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

550 University Blvd
#3240
Indianapolis, IN 46202
Phone (317) 274-7740

Interoperability endpoints

  • Direct secure messaging: lmark13609@direct.eskenazihealth.edu
  • Direct secure messaging: lmark3@direct.iuhealth.org

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609286400000",
    "number": "1720025372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 UNIVERSITY BLVD",
            "address_2": "UH 3240",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025149",
            "telephone_number": "317-274-7741",
            "fax_number": "317-274-7051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARK",
        "first_name": "LAWRENCE",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IN",
            "license": "01062068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200822500",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lmark3@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "550 University Blvd",
            "address_2": "UH 3240",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462025149",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lmark3@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "550 University Blvd",
            "address_2": "UH 3240",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462025149",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lmark13609@direct.eskenazihealth.edu",
            "affiliation": "Y",
            "affiliationName": "Eskenazi Health",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "720 Eskenazi Ave # F2-111",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462025187",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.