Mark S. Adickes, MD

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

M3840 Issued in TX

Practice address

950 Campbell Road
Houston, TX 77024

Phone

(713) 464-0077

Fax

(713) 464-9582

NPI assigned

Oct 13, 2006

Last updated

Dec 6, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Orthopedic Surgery

Education

Harvard Medical School, 2000

Medicare assignment

May accept Medicare assignment

Group practices

Mark Provenzano MD PAGroup PAC ID 1557413044, 5 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Mark Provenzano MD PA

  dba The Orthopedic Sports Clinic

  • Specialist
  • Houston, TX
  • NPI 1720261456
  Medicare reassignment Care Compare group
• Advanced Surgeons & Physicians Network, Inc.

  dba Advanced Medical Group

  • Family Medicine Physician
  • Houston, TX
  • NPI 1508030917
  Medicare reassignment NPD
• Baylor College of Medicine

  dba HCHD Community Medicine

  • Family Medicine Physician
  • Houston, TX
  • NPI 1053352914
  Medicare reassignment NPD
• Baylor College of Medicine

  dba BCM Physicians

  • Ph.D. Medical Genetics
  • Houston, TX
  • NPI 1881026664
  Medicare reassignment NPD
• Baylor College of Medicine

  • Internal Medicine Physician
  • Houston, TX
  • NPI 1104867175
  NPD
• Baylor College of Medicine

  • Orthopaedic Surgery Physician
  • Sugar Land, TX
  • NPI 1700683844

  Sports Medicine

  NPD
• Steadman Clinic Professional LLC

  • Specialist
  • Vail, CO
  • NPI 1952327835

  Sports Medicine

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1770673428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 CAMPBELL ROAD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77024",
            "telephone_number": "713-464-0077",
            "fax_number": "713-464-9582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 CAMPBELL ROAD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77024",
            "telephone_number": "713-464-0077",
            "fax_number": "713-464-9582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADICKES",
        "first_name": "MARK",
        "middle_name": "S.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "TX",
            "license": "M3840",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8W7163",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "01042041",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00435684",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Linda Nerea Adhiambo
• Binaya Adhikari, MD
• Nandani Adhyapak
• Adibams Healthcare PLLC
• Shawn S Adibi, DDS, MED
• Jennifer Lynn Adicks, D.D.S.
• Adidel Inc (Adidel Healthcare Services)
• Uloma C Adiele
• Jennifer Adigun
• Moriam Adigun, DC, MS, MED

• Sports Medicine (Orthopaedic Surgery) Physician in Houston, TX
• Providers in Houston, TX by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.