NPIMap

Individual provider Active NPI

Mark Patrick Connor, M.D.

  • Hospitalist Physician
  • Kirkland, WA
National Provider Identifier
1801244462
Registry record updated Oct 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
60968575 Issued in WA
Practice address
12040 NE 128TH St # Ms 105
Kirkland, WA 98034
Phone
(425) 899-2563
Fax
(425) 899-2079
NPI assigned
May 24, 2016
Last updated
Oct 7, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 60968575 WA Primary

Addresses

Primary practice location

12040 NE 128TH St # Ms 105
Kirkland, WA 98034

Mailing address

12040 NE 128TH St # Ms 105
Kirkland, WA 98034-3013
Phone (425) 899-2563

Other practice location 1

15 York St
YNHH Dept of Medicine, LMP 1092
New Haven, CT 06510-3221
Phone (203) 688-5555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20191007000973 WA Practitioner - Internal Medicine 4082908892 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Georgetown University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12040 NE 128TH St
Ms 105
Kirkland, WA 98034-3013
Phone (425) 899-2560

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.73 of 100Reported as apm
Quality
73.46
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60968575WAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
King County Public Hospital District No. 2 Multi-Specialty CurrentSince Sep 1, 2019 Accepting new patients
King County Public Hospital District No 2 Multi-Specialty CurrentSince Sep 1, 2019 Accepting new patients
King County Public Hospital District No 2 Multi-Specialty Current Accepting new patients
King County Public Hospital District No. 2 Past Accepting new patients
King County Public Hospital District No 2 Multi-Specialty Past Accepting new patients

Locations

12039 NE 128th St
Ste 300
Kirkland, WA 98034
Phone (425) 899-3123

12040 NE 128th St
#105
Kirkland, WA 98034
Phone (425) 899-2560

12040 NE 128th St
#50
Kirkland, WA 98034
Phone (425) 899-1894

Organizations & group practices 5

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": "1464048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570406400000",
    "number": "1801244462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12040 NE 128TH ST # MS 105",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343013",
            "telephone_number": "425-899-2563",
            "fax_number": "425-899-2079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12040 NE 128TH ST # MS 105",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "98034",
            "telephone_number": "425-899-2563",
            "fax_number": "425-899-2079"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 York St",
            "address_2": "YNHH Dept of Medicine, LMP 1092",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065103221",
            "country_code": "US",
            "telephone_number": "203-688-5555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONNOR",
        "first_name": "MARK",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-24",
        "last_updated": "2019-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WA",
            "license": "60968575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

Verify at the official NPI Registry.