Mark Andrew Lyerly, MD

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

35415 Issued in NC

Practice address

190 Kimel Park Dr Ste 155
Winston Salem, NC 27103-6946

Phone

(336) 765-6637

Fax

(336) 765-6964

NPI assigned

Mar 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 5

Medicare fee-for-service enrollment

Enrolled in WV, ME2 enrollments

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 2

Specialty

Neurosurgery

Education

Duke University School of Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

St Joseph HospitalGroup PAC ID 6406766336, 197 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joseph Hospital Hospital, Bangor, ME, CCN 200001
• Northern Light Eastern Maine Medical Center Hospital, Bangor, ME, CCN 200033
• Northern Light C a Dean Hospital Hospital, Greenville, ME, CCN 201301
• Down East Community Hospital Hospital, Machias, ME, CCN 201311

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mlyerly1349754@direct.bsmhealth.org
• Direct secure messaging: lyerly1349754@direct.bsmhealth.org
• Direct secure messaging: mlyerly144815@direct.novanthealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• St. Joseph Hospital

  • General Acute Care Hospital
  • Bangor, ME
  • NPI 1154321545
  Medicare reassignment Care Compare group NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Charles a Dean Memorial Hospital

  • Critical Access Hospital
  • Greenville, ME
  • NPI 1659388213
  Care Compare affiliation
• Down East Community Hospital

  • Critical Access Hospital
  • Machias, ME
  • NPI 1528087004
  Care Compare affiliation
• Eastern Maine Medical Center

  • General Acute Care Hospital
  • Bangor, ME
  • NPI 1790789147
  Care Compare affiliation
• St. Joseph Hospital

  • General Acute Care Hospital
  • Bangor, ME
  • NPI 1154321545
  Care Compare affiliation

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1881661791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 KIMEL PARK DR STE 155",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036946",
            "telephone_number": "336-765-6637",
            "fax_number": "336-765-6964"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "880 N Tennessee Ave Ste 104",
            "address_purpose": "LOCATION",
            "city": "Martinsburg",
            "state": "WV",
            "postal_code": "254019401",
            "country_code": "US",
            "telephone_number": "304-596-5160",
            "fax_number": "304-596-5161",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "360 Broadway",
            "address_purpose": "LOCATION",
            "city": "Bangor",
            "state": "ME",
            "postal_code": "044013900",
            "country_code": "US",
            "telephone_number": "207-907-1617",
            "fax_number": "207-907-1627",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1226 Eastchester Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "High Point",
            "state": "NC",
            "postal_code": "272653116",
            "country_code": "US",
            "telephone_number": "336-481-8670",
            "fax_number": "336-481-8679",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LYERLY",
        "first_name": "MARK",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "ME",
            "license": "MD25702",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "WV",
            "license": "29021",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NC",
            "license": "35415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mlyerly140082@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "13 Western Maryland Pkwy Ste 106",
            "city": "Hagerstown",
            "state": "MD",
            "country_code": "US",
            "postal_code": "217406474",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lyerly1349754@direct.bsmhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "360 Broadway",
            "city": "Bangor",
            "state": "ME",
            "country_code": "US",
            "postal_code": "044013900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mlyerly140082@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "13 Western Maryland Pkwy Ste 106",
            "city": "Hagerstown",
            "state": "MD",
            "country_code": "US",
            "postal_code": "217406474",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mlyerly140082@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "13 Western Maryland Pkwy Ste 106",
            "city": "Hagerstown",
            "state": "MD",
            "country_code": "US",
            "postal_code": "217406474",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mlyerly144815@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "190 Kimel Park Dr Ste 155",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271036946",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Thomas William Lycan Jr., D.O.
• Brittany Lyda, PHARMD
• Brittany Autumn Lyda
• Victoria Jane Lydon, MSW, LCSW
• Elizabeth Susan Lyerly, PA-C
• Lyfes New Direction
• Earl Jr Lyles
• Mary Fennell Lyles, MD
• Lyn P. Carpenter, PH.D., PLLC
• Ashley Lynch

• Neurological Surgery Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Neurological Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.