Eddie Kevin Mark, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN2297770 Issued in MA

Practice address

55 Lake Ave N
Worcester, MA 01655-0002

Phone

(774) 442-2853

Fax

(774) 443-7042

NPI assigned

Aug 5, 2014

Last updated

Feb 11, 2015By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Seattle Childrens HospitalGroup PAC ID 9032021050, 113 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: emark26035@direct.seattlechildrens.org

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.

• Seattle Children's Hospital

  • Specialist
  • Seattle, WA
  • NPI 1003319500
  Medicare reassignment Care Compare group NPD
• The Association of Chrmc and University Physicians

  dba Children's University Medical Group

  • Pediatrics Physician
  • Seattle, WA
  • NPI 1255449963
  Medicare reassignment NPD
• Association of CHMC and University Physicians

  • Pediatrics Physician
  • Richland, WA
  • NPI 1851680664
  NPD
• Seattle Childrens Hospital

  dba Seattle Childrens Outpatient Pharmacy

  • Clinic Pharmacy
  • Seattle, WA
  • NPI 1245342153
  NPD
• Seattle Children's Hospital

  • Home Infusion Agency
  • Bothell, WA
  • NPI 1245383348
  NPD (past)

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

{
    "created_epoch": "1407196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423612800000",
    "number": "1922417807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348",
            "telephone_number": "800-225-8885",
            "fax_number": "508-334-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "774-442-2853",
            "fax_number": "774-443-7042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARK",
        "first_name": "EDDIE",
        "middle_name": "KEVIN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-05",
        "last_updated": "2015-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2297770",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CT",
            "license": "5790",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MA",
            "license": "RN2297770",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arianna Marino, LCSW
• Katherine Rose Marino, M.D., PH.D.
• Brianna Marion, LMT
• Matthew Mariyampillai, MD
• Mark a. Aversa MD PC
• Joseph Gerard Markeseines, AGACNP-BC
• Jennifer Anne Markey, NP
• Yvonnne Akusika Markham
• Kristen Markie, M.D.
• Herbert Markley, MD

• Nurse Practitioner in Worcester, MA
• Providers in Worcester, MA by specialty
• Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2015; 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.