Individual provider Active NPI

Mark Raybeck, M.D.

  • Anesthesiology Physician
  • San Diego, CA
National Provider Identifier
1730174806
Registry record updated Aug 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A74922 Issued in CA
Practice address
3444 Kearny Villa Rd Ste 100
San Diego, CA 92123-1960
Phone
(858) 268-3566
NPI assigned
Sep 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A74922 CA Primary

Addresses

Primary practice location

3444 Kearny Villa Rd Ste 100
San Diego, CA 92123-1960

Mailing address

909 Squalicum Way
Ste 102
Bellingham, WA 98225-2077
Phone (360) 647-3377

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20190910003624 WA Practitioner - Anesthesiology 1254350069 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Pennsylvania State University College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bellingham Anesthesia Associates PSGroup PAC ID 6406755990, 52 clinicians

Practice addresses (Care Compare)

909 Squalicum Way
Suite 102
Bellingham, WA 98225-2077
Phone (360) 647-3377

Hospital & facility affiliations

  • Skagit Valley Hospital Hospital, Mount Vernon, WA, CCN 500003
  • Peacehealth St Joseph Medical Center Hospital, Bellingham, WA, CCN 500030

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A74922CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bellingham Anesthesia Associates, P.S. Anesthesiology CurrentSince Aug 12, 2019 Accepting new patients

Locations

909 Squalicum Way
Ste 102
Bellingham, WA 98225
Phone (360) 647-3377

Organizations & group practices 1

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 4

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": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565654400000",
    "number": "1730174806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 SQUALICUM WAY",
            "address_2": "STE 102",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982252077",
            "telephone_number": "360-647-3377",
            "fax_number": "360-752-3214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3444 KEARNY VILLA RD STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231960",
            "telephone_number": "858-268-3566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYBECK",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-15",
        "last_updated": "2019-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A74922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.