Mark J Freeman, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G47688 Issued in CA

Practice address

15322 Lakeshore Dr
Ste 101
Clearlake, CA 95422-9815

Phone

(707) 995-1362

Fax

(707) 995-7057

NPI assigned

Jun 1, 2005

Last updated

Apr 17, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: mark.freeman.p1@direct.lcthc.nextgenshare.com

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 Freeman, MD

  • Family Medicine Physician
  • Clearlake, CA
  • NPI 1356426910
  NPD (past) Authorized official
• Michael R. Cosenza, DPM, Inc.

  • Primary Podiatric Medicine Podiatrist
  • Ukiah, CA
  • NPI 1316459787
  NPD (past)
• Quantum Healthcare Medical Associates Inc.

  • Hospitalist Physician
  • Colton, CA
  • NPI 1568490597

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239926400000",
    "number": "1801898929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15322 LAKESHORE DR",
            "address_2": "STE 101",
            "city": "CLEARLAKE",
            "state": "CA",
            "postal_code": "954229815",
            "telephone_number": "707-995-1362",
            "fax_number": "707-995-7057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15322 LAKESHORE DR",
            "address_2": "STE 101",
            "city": "CLEARLAKE",
            "state": "CA",
            "postal_code": "954229815",
            "telephone_number": "707-995-1362",
            "fax_number": "707-995-7057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "MARK",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2009-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G47688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra Marie Fleming, RASI
• Angelic Julia Flores
• Yolanda Estella Flores, PSYCHIATRIC TECHNICI
• Leslie Suzanne Frances, RRW
• Katherine Judith Freeman
• Nadya Friedman
• Lori Frinzell
• Jennifer Anne Frolich, RAS
• Wendy Fullam
• Rebecca Ann Furia

• Family Medicine Physician in Clearlake, CA
• Providers in Clearlake, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.