NPIMap

Individual provider Active NPI

Mark Bevan, M.D.

  • Nephrology Physician
  • Farmington, NM
National Provider Identifier
1720185788
Registry record updated Mar 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
82-11 Issued in NM
Practice address
812 W Maple St
Farmington, NM 87401-5631
Phone
(505) 326-6521
Fax
(505) 325-6699
NPI assigned
Sep 20, 2006
Last updated
Mar 19, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 82-11 NM Primary

Addresses

Primary practice location

812 W Maple St
Farmington, NM 87401-5631

Mailing address

622 W Maple St Ste H
Farmington, NM 87401-6589
Phone (505) 326-6521

Other identifiers 4

IdentifierTypeStateIssuer
225442MedicaidAZ
T0078MedicaidUT
91082115MedicaidCO
23325MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NM, UT, AZ, CO5 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
I20040116000883 TX Practitioner - Internal MedicinePractitioner - Nephrology 4284544560 Reassigns benefits to 4 organizations
I20100920001130 NM Practitioner - Nephrology 4284544560 Reassigns benefits to 1 organization
I20101116000922 UT Practitioner - NephrologyPractitioner - Internal Medicine 4284544560 Reassigns benefits to 1 organization
I20120203000630 AZ Practitioner - Neurology 4284544560 Reassigns benefits to 1 organization
I20120911000236 CO Practitioner - NephrologyPractitioner - Internal Medicine 4284544560 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Duke University School of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Four Corners Nephrology Associates PCGroup PAC ID 6204721731, shared by 2 NPIs, 4 clinicians
DHHS PHS Naihs Shiprock HospitalGroup PAC ID 0749193837, 148 clinicians

Practice addresses (Care Compare)

167 N Main St
Tuba City Indian Medical Center
Tuba City, AZ 86045-0600
Phone (928) 283-2094

1902 E 2ND Ave
Durango, CO 81301-5021
Phone (505) 326-6521

312 S Lake St
Farmington, NM 87401-5620

312 S Lake St
Farmington, NM 87401-6589

500 Edgewater Dr
Tuba City, AZ 86045-2905
Phone (505) 326-6521

610 E Main St
Suite C
Cortez, CO 81321-3308
Phone (970) 565-4330

802 S 200
Blanding, UT 84511-3910
Phone (505) 326-6521

812 W Maple St
Farmington, NM 87401-5631
Phone (505) 326-6521

Highway
Suite 174
Kayenta, AZ 86033-9997
Phone (505) 326-6521

Highway 191 and Hospital Rd
Chinle, AZ 86503-8000
Phone 92867470307030

Highway 491
Shiprock, NM 87420-0160
Phone 50536860016401

P O Box
160 Attn Business Office
Shiprock, NM 87420-0160

PO Box
Suite 160
Shiprock, NM 87420-0160

US Hwy 160
BLDG 2000 Dennehotso Health Ctr
Dennehotso, AZ 86535-2000
Phone (928) 697-4000

US Hwy 160 S
MP 394
Kayenta, AZ 86033-0368
Phone (928) 697-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.26 of 100Reported as group
Quality
74.27
Improvement activities
40
Cost
78.06

Merit-based Incentive Payment System (MIPS)

Final score
77.59 of 100Reported as group
Quality
47.51
Promoting interoperability
69
Improvement activities
40
Cost
86.96

Merit-based Incentive Payment System (MIPS)

Final score
21.04 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
70.13

Merit-based Incentive Payment System (MIPS)

Final score
80.86 of 100Reported as group
Quality
61.32
Improvement activities
40
Cost
90.46

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Four Corners Nephrology Associates PC Nephrology CurrentSince Jul 1, 1966 Accepting new patients
DHHS PHS Naihs Chinle Comprehensive Health Care Facility CurrentSince Dec 30, 2017 Accepting new patients
Four Corners Nephrology Associates PC Nephrology CurrentSince Jul 1, 1966 Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Nov 1, 1996 Accepting new patients
Tuba City Regional Health Care Corporation CurrentSince Mar 2, 2024 Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Nov 1, 1996 Accepting new patients
Kayenta Alternative Rural Hospital Past Accepting new patients

Locations

1902 E 2nd Ave
Durango, CO 81301
Phone (505) 326-6521

312 S Lake St
Farmington, NM 87401

622 W Maple St
Ste H
Farmington, NM 87401
Phone (505) 326-6521

812 W Maple St
Farmington, NM 87401
Phone (505) 326-6521

802 S 200 W
Blanding, UT 84511
Phone (435) 678-3869

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.72546
  • Direct secure messaging: mark.bevan.1@16299.direct.athenahealth.com

Organizations & group practices 9

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 10

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584576000000",
    "number": "1720185788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 W MAPLE ST STE H",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874016589",
            "telephone_number": "505-326-6521",
            "fax_number": "505-325-6699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 W MAPLE ST",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874015631",
            "telephone_number": "505-326-6521",
            "fax_number": "505-325-6699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEVAN",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-03-19",
        "certification_date": "2020-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NM",
            "license": "82-11",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "225442",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T0078",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "91082115",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "23325",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, NM

Sources for this page

Verify at the official NPI Registry.