NPIMap

Individual provider Active NPI

Mark R Connell, M.D.

  • Diagnostic Radiology Physician
  • Foley, AL
National Provider Identifier
1730146069
Registry record updated Dec 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
24737 Issued in AL
Practice address
1613 N McKenzie St
Foley, AL 36535-2247
Phone
(251) 476-5443
Fax
(251) 476-0116
NPI assigned
Apr 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 24737 AL Primary

Addresses

Primary practice location

1613 N McKenzie St
Foley, AL 36535-2247

Mailing address

PO Box 7866
Mobile, AL 36670-0866
Phone (251) 476-5443

Other identifiers 10

IdentifierTypeStateIssuer
009936421MedicaidAL
51003532OtherALBC MONTCLAIR
009936423MedicaidAL
51003530OtherALBC GREYSTONE
51003540OtherALBC SYLACAUGA
51003538OtherALBC SHELBY
009936422MedicaidAL
009936426MedicaidAL
009936424MedicaidAL
51003539OtherALBC 280

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060810000380 AL Practitioner - Diagnostic Radiology 4981607017 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Alabama School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Baldwin Diagnostic Imaging Associates, P.C.Group PAC ID 1254380769, 4 clinicians

Practice addresses (Care Compare)

101 E 15TH Ave Hwy 9
Gulf Shores, AL 36535-2247
Phone (251) 949-3400

1613 N McKenzie St
Foley, AL 36535-2247
Phone (251) 949-3513

Hospital & facility affiliations

  • Baldwin Health Hospital, Foley, AL, CCN 010083
  • Thomas Hospital Hospital, Fairhope, AL, CCN 010100
  • Mobile Infirmary Medical Center Hospital, Mobile, AL, CCN 010113
  • USA Health University Hospital Hospital, Mobile, AL, CCN 010087
  • Springhill Medical Center Hospital, Mobile, AL, CCN 010144

Merit-based Incentive Payment System (MIPS)

Final score
96.21 of 100Reported as group
Quality
100
Improvement activities
40
Cost
87.36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
24737ALMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Baldwin Diagnostic Imagine Associates, P.C. CurrentSince Jan 1, 2011 Accepting new patients
Radiology Associates of Pensacola, PA Diagnostic Radiology Past Accepting new patients
Orthopaedic Specialists of Alabama, PC Past Accepting new patients
West Florida Medical Center Clinic PA Past Accepting new patients
Robert Eichelberger, M.D., P.C. Past Accepting new patients
Orthopaedic Specialists of Alabama PC Past Accepting new patients

Locations

1613 N McKenzie St
Foley, AL 36535
Phone (251) 949-3400

Organizations & group practices 6

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": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292371200000",
    "number": "1730146069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7866",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366700866",
            "telephone_number": "251-476-5443",
            "fax_number": "251-476-0116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1613 N MCKENZIE ST",
            "city": "FOLEY",
            "state": "AL",
            "postal_code": "365352247",
            "telephone_number": "251-476-5443",
            "fax_number": "251-476-0116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNELL",
        "first_name": "MARK",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-28",
        "last_updated": "2010-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AL",
            "license": "24737",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009936421",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC MONTCLAIR",
            "identifier": "51003532",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009936423",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC GREYSTONE",
            "identifier": "51003530",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC SYLACAUGA",
            "identifier": "51003540",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC SHELBY",
            "identifier": "51003538",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009936422",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009936426",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009936424",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC 280",
            "identifier": "51003539",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Foley, AL

Sources for this page

Verify at the official NPI Registry.