Individual provider Active NPI

Mark Vikas Mishra, M.D.

  • Radiation Oncology Physician
  • Bel Air, MD
National Provider Identifier
1790932630
Registry record updated Sep 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
MT194731 Issued in PA
Practice address
500 Upper Chesapeake Drive Radiation Oncology
Upper Chesapeake Medical Center
Bel Air, MD 21014-4324
Phone
(443) 843-5609
NPI assigned
Aug 21, 2008
Last updated
Sep 20, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125-055026 IL
Radiation Oncology Physician 2085R0001X MT194731 PA Primary

Addresses

Primary practice location

500 Upper Chesapeake Drive Radiation Oncology
Upper Chesapeake Medical Center
Bel Air, MD 21014-4324

Mailing address

500 Upper Chesapeake Drive Radiation Oncology
Upper Chesapeake Medical Center
Bel Air, MD 21014-4324
Phone (443) 843-5609

Other identifiers 2

IdentifierTypeStateIssuer
D75962OtherMDLICENSE NUMBER
MT 194731OtherPASTATE MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20130801000755 MD Practitioner - Radiation OncologyPractitioner - Diagnostic Radiology 1951542950 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
University of Cincinnati College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maryland Proton Treatment Center, LLCGroup PAC ID 5597070524, 23 clinicians

Practice addresses (Care Compare)

219 S Washington St
Um Shore Regional Medical Center
Easton, MD 21601-2913
Phone (410) 822-1000

22 S Green St
Baltimore, MD 21201-1544
Phone (410) 328-6080

850 W Baltimore St
Baltimore, MD 21201-1154
Phone (410) 227-7434

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125-055026ILMDInternal Medicine Physician
MT194731PAMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baltimore Washington Medical Center Inc. Radiation Oncology CurrentSince Nov 1, 2013 Accepting new patients
Maryland Proton Treatment Center, LLC CurrentSince Sep 1, 2015 Accepting new patients
University of Maryland Community Medical Group, Inc. CurrentSince Sep 16, 2018 Accepting new patients
University of Maryland Radiation Oncology Associates PA Radiation Oncology CurrentSince Aug 18, 2013 Accepting new patients
Baltimore Washington Medical Center Inc. CurrentSince Nov 1, 2013 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

850 W Baltimore St
Baltimore, MD 21201
Phone (410) 227-7434

500 Upper Chesapeake Dr
Bel Air, MD 21014
Phone (443) 643-1000

2540 Centreville Rd
Centreville, MD 21617
Phone (410) 758-4432

10710 Charter Dr
Ste G030
Columbia, MD 21044
Phone (443) 546-1300

219 S Washington St
Easton, MD 21601

509 Idlewild Ave
Easton, MD 21601
Phone (410) 820-6411

301 Hospital Dr
Glen Burnie, MD 21061
Phone (410) 787-4565

305 Hospital Dr
Glen Burnie, MD 21061
Phone (410) 553-8100

305 Hospital Dr
Ste E
Glen Burnie, MD 21061

Interoperability endpoints

  • Direct secure messaging: mmishra83262@direct.umm.edu

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

Hospital & facility affiliations 5

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": "1219276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379635200000",
    "number": "1790932630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 UPPER CHESAPEAKE DRIVE RADIATION ONCOLOGY",
            "address_2": "UPPER CHESAPEAKE MEDICAL CENTER",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210144324",
            "telephone_number": "443-843-5609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 UPPER CHESAPEAKE DRIVE RADIATION ONCOLOGY",
            "address_2": "UPPER CHESAPEAKE MEDICAL CENTER",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210144324",
            "telephone_number": "443-843-5609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISHRA",
        "first_name": "MARK",
        "middle_name": "VIKAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-21",
        "last_updated": "2013-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125-055026",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "PA",
            "license": "MT194731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "D75962",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "MT 194731",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bel Air, MD

Sources for this page

Verify at the official NPI Registry.