NPIMap

Individual provider Active NPI

Mark Wayne Hogge, MD

  • Diagnostic Radiology Physician
  • Jamestown, NY
National Provider Identifier
1942258967
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
J1461 Issued in TX
Practice address
796 Fairmount Ave # We
Jamestown, NY 14701-2547
Phone
(716) 664-9731
Fax
(716) 664-9160
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X J1461 TX Primary

Addresses

Primary practice location

796 Fairmount Ave # We
Jamestown, NY 14701-2547

Mailing address

PO Box 788
Jamestown, NY 14702-0788
Phone (214) 926-8614

Other identifiers 1

IdentifierTypeStateIssuer
128608002MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20181031001496 PA Practitioner - Diagnostic Radiology 0840210779 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Eastern Virginia Medical School, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Susquehanna Imaging Associates, Inc.Group PAC ID 3870482409, 8 clinicians

Practice addresses (Care Compare)

1100 Grampian Blvd
Williamsport, PA 17701-1907
Phone (570) 326-8171

1112 Grampian Blvd
Williamsport, PA 17701-1909
Phone (570) 326-8355

1205 River Ave
Williamsport, PA 17701-3724
Phone (570) 320-7407

900 Plaza Dr
Montoursville, PA 17754-2448
Phone (570) 601-8550

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.99 of 100Reported as group
Quality
85.98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
J1461TXMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Susquehanna Imaging Associates, Inc. Diagnostic Radiology CurrentSince Oct 15, 2018 Accepting new patients
Premier Open MRI of Plano Past Accepting new patients
Preferred Imaging of Plano, LLC Past Accepting new patients

Locations

1100 Grampian Blvd
Williamsport, PA 17701
Phone (570) 326-8005

700 High St
Williamsport, PA 17701
Phone (570) 321-1000

Organizations & group practices 3

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.

Hospital & facility affiliations 41

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

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1942258967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 788",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147020788",
            "telephone_number": "214-926-8614",
            "fax_number": "716-664-9160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "796 FAIRMOUNT AVE # WE",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147012547",
            "telephone_number": "716-664-9731",
            "fax_number": "716-664-9160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGGE",
        "first_name": "MARK",
        "middle_name": "WAYNE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "J1461",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128608002",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamestown, NY

Sources for this page

Verify at the official NPI Registry.