Individual provider Active NPI

Mark Glenn Cleveland, MD

  • Dermatology Physician
  • Cedar Rapids, IA
National Provider Identifier
1720086523
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
31130 Issued in IA
Practice address
411 10TH St SE Ste 1200
Cedar Rapids, IA 52403-2449
Phone
(319) 362-3434
Fax
(319) 362-9568
NPI assigned
Jul 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery Physician 207ND0101X 31130 IA
Dermatology Physician 207N00000X 31130 IA Primary

Addresses

Primary practice location

411 10TH St SE Ste 1200
Cedar Rapids, IA 52403-2449

Mailing address

411 10TH St SE Ste 1200
Cedar Rapids, IA 52403-2449
Phone (319) 362-3434

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20100320000190 IA Practitioner - DermatologyPractitioner - Micrographic Dermatologic Surgery (MDS) 8426940933 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
DermatologyAlso: Micrographic Dermatologic Surgery (MDS)
Education
University of Texas Medical Branch at Galveston, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State University of IowaGroup PAC ID 7618884230, 1,886 clinicians

Practice addresses (Care Compare)

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 356-1616

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.45 of 100Reported as group
Promoting interoperability
97
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
80.02 of 100Reported as group
Quality
75.68
Promoting interoperability
78
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions222
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy79

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31130IAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State University of Iowa CurrentSince Oct 31, 2024 Accepting new patients
State University of Iowa Past Accepting new patients

Locations

411 10th St SE
Ste 1200
Cedar Rapids, IA 52403
Phone (319) 362-3434

200 Hawkins Dr
Iowa City, IA 52242
Phone (319) 356-1616

200 Hawkins Dr
#H
Iowa City, IA 52242
Phone (319) 356-1616

105 E 9th St
Iowa City, IA 52241
Phone (319) 467-2000

407 S White St
Mt Pleasant, IA 52641
Phone (319) 385-6110

Organizations & group practices 2

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 2

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": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1720086523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 10TH ST SE STE 1200",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524032449",
            "telephone_number": "319-362-3434",
            "fax_number": "319-362-9568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 10TH ST SE STE 1200",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524032449",
            "telephone_number": "319-362-3434",
            "fax_number": "319-362-9568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEVELAND",
        "first_name": "MARK",
        "middle_name": "GLENN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "IA",
            "license": "31130",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IA",
            "license": "31130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

Verify at the official NPI Registry.