Individual provider Active NPI

Gary D Marks, DO

  • Emergency Medicine Physician
  • Medford, OR
National Provider Identifier
1861569212
Registry record updated Apr 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
DO21010 Issued in OR
Practice address
2825 E Barnett Rd
Medford, OR 97504-8332
Phone
(541) 789-7000
NPI assigned
Nov 29, 2006
Last updated
Apr 2, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X DO21010 OR Primary

Addresses

Primary practice location

2825 E Barnett Rd
Medford, OR 97504-8332

Mailing address

PO Box 4749
Medford, OR 97501-0227
Phone (541) 789-5516

Other identifiers 1

IdentifierTypeStateIssuer
151272MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20041123000410 OR Practitioner - Emergency Medicine 8325003916 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
College of Osteo Med of the Pacific at Pomona, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
AsanteGroup PAC ID 0547177321, 141 clinicians

Practice addresses (Care Compare)

2825 E Barnett Rd
Medford, OR 97504-8332
Phone (541) 789-7000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO21010ORMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Asante CurrentSince Jul 1, 1998 Accepting new patients
Asante CurrentSince Jul 1, 1998 Accepting new patients
Asante Physician Partners CurrentSince Apr 1, 2018 Accepting new patients
Asante Past Accepting new patients
Medford Medical Clinic, LLP PastSince Nov 1, 1999 Accepting new patients

Locations

280 Maple St
Ashland, OR 97520
Phone (541) 201-4000

625 SW Ramsey Ave
Ste A
Grants Pass, OR 97527
Phone (541) 474-5004

2825 E Barnett Rd
Medford, OR 97504
Phone (541) 282-6770

555 Black Oak Dr
Ste 100
Medford, OR 97504
Phone (541) 774-5894

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 1

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": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364860800000",
    "number": "1861569212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4749",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975010227",
            "telephone_number": "541-789-5516",
            "fax_number": "541-789-5518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 E BARNETT RD",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048332",
            "telephone_number": "541-789-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKS",
        "first_name": "GARY",
        "middle_name": "D",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2013-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "DO21010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "151272",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.