NPIMap

Individual provider Active NPI

Mark H. Entrup, D.O.

  • Internal Medicine Physician
  • Springfield, MO
National Provider Identifier
1841300761
Registry record updated Mar 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
100131 Issued in MO
Practice address
3801 S National Ave
Springfield, MO 65807-5210
Phone
(417) 269-7728
Fax
(417) 269-7729
NPI assigned
Aug 30, 2006
Last updated
Mar 23, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 100131 MO Primary

Addresses

Primary practice location

3801 S National Ave
Springfield, MO 65807-5210

Mailing address

PO Box 4046
Springfield, MO 65808-4046
Phone (417) 269-5712

Other identifiers 2

IdentifierTypeStateIssuer
10066OtherBLUE CROSS MO
246655427MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20070216000013 MO Practitioner - Internal Medicine 7618079906 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
R Franklin University of Med & Sci/Chicago Medical School, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lester E Cox Medical CentersGroup PAC ID 5799787784, 240 clinicians

Practice addresses (Care Compare)

3801 S National Ave
Springfield, MO 65807-5210
Phone (417) 269-7820

3801 S National Ave
Springfield, MO 65807-6090
Phone (417) 269-7728

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.78 of 100Reported as group
Quality
74.39
Promoting interoperability
100
Improvement activities
40
Cost
78.21

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
100131MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lester E Cox Medical Centers CurrentSince Jan 1, 2007 Accepting new patients
Lester E Cox Medical Centers CurrentSince Jan 1, 2007 Accepting new patients
Lester E Cox Medical Centers Past Accepting new patients
Lester E. Cox Medical Centers Past Accepting new patients
Lester E Cox Medical Centers Past Accepting new patients
Ozarks Medical Center Past Accepting new patients
Lester E Cox Medical Centers Internal Medicine Past Accepting new patients

Locations

3800 S National Ave
Ste LL100
Springfield, MO 65807
Phone (417) 269-7784

3801 S National Ave
Springfield, MO 65807
Phone (417) 269-4056

3801 S National Ave
Fl 5
Springfield, MO 65807

3801 S National Ave
Ste 1122
Springfield, MO 65807

Organizations & group practices 7

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584921600000",
    "number": "1841300761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4046",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658084046",
            "telephone_number": "417-269-5712",
            "fax_number": "417-269-7567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 S NATIONAL AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075210",
            "telephone_number": "417-269-7728",
            "fax_number": "417-269-7729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENTRUP",
        "first_name": "MARK",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-03-23",
        "certification_date": "2020-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "100131",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS MO",
            "identifier": "10066",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "246655427",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.