Individual provider Active NPI

Mark Daniel Cook, M.D.

  • Family Medicine Physician
  • Oakdale, CA
National Provider Identifier
1750379236
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A60965 Issued in CA
Practice address
1425 W H St
Ste 200
Oakdale, CA 95361-3588
Phone
(209) 848-1005
Fax
(209) 845-8918
NPI assigned
Oct 10, 2005
Last updated
Feb 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A60965 CA Primary

Addresses

Primary practice location

1425 W H St
Ste 200
Oakdale, CA 95361-3588

Mailing address

1425 W H St
Ste 200
Oakdale, CA 95361-3588
Phone (209) 848-1005

Other identifiers 1

IdentifierTypeStateIssuer
00A609650MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20070723000403 CA Practitioner - Family Practice 4486755303 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, San Diego School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mark D Cook, MD, IncGroup PAC ID 9830347707, 2 clinicians

Practice addresses (Care Compare)

1425 W H St
Suite 200
Oakdale, CA 95361-3590
Phone (209) 848-1005

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60965CAMDMarriage & Family Therapist
A60965CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mark D Cook, MD, Inc Family Medicine CurrentSince Sep 15, 2012 Accepting new patients

Locations

1425 W H St
Ste 200
Oakdale, CA 95361
Phone (209) 848-1005

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1750379236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 W H ST",
            "address_2": "STE 200",
            "city": "OAKDALE",
            "state": "CA",
            "postal_code": "953613588",
            "telephone_number": "209-848-1005",
            "fax_number": "209-845-8918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 W H ST",
            "address_2": "STE 200",
            "city": "OAKDALE",
            "state": "CA",
            "postal_code": "953613588",
            "telephone_number": "209-848-1005",
            "fax_number": "209-845-8918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "MARK",
        "middle_name": "DANIEL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-10",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A60965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A609650",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakdale, CA

Sources for this page

Verify at the official NPI Registry.