Mark Kortbaoui, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OP61564493 Issued in WA

Practice address

320 W 10TH Ave Ste 202
Kennewick, WA 99336-6302

Phone

(509) 221-5520

NPI assigned

Apr 1, 2019

Last updated

Oct 9, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Specialty

Family Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prosser Public Hospital District of Benton CountyGroup PAC ID 6709787872, shared by 5 NPIs, 111 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Prosser Memorial Hospital Hospital, Prosser, WA, CCN 501312
• Kadlec Regional Medical Center Hospital, Richland, WA, CCN 500058

Merit-based Incentive Payment System (MIPS)

Final score

94.35 of 100Reported as apm

Quality

85.05

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mkortbaoui97815@edirect.chehr.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.

• Central Washington Health Services Association

  dba Confluence Health

  • Emergency Medical Services (Emergency Medicine) Physician
  • Wenatchee, WA
  • NPI 1801937453
  NPD

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

• Kadlec Regional Medical Center

  • General Acute Care Hospital
  • Richland, WA
  • NPI 1972507580
  Care Compare affiliation
• Prosser Public Hospital District of Benton County

  dba Prosser Memorial Health

  • Critical Access Hospital
  • Prosser, WA
  • NPI 1306897681
  Care Compare affiliation

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

{
    "created_epoch": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1942762851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 NE 110TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972203134",
            "telephone_number": "908-943-6247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 W 10TH AVE STE 202",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993366302",
            "telephone_number": "509-221-5520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORTBAOUI",
        "first_name": "MARK",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-01",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP61564493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deneen F. Koch
• Wayne Michael Kohan, MD
• Michael Kolczynski, M.D.
• Sandra Kay Kolp
• Christopher Kontogianis, M.D.
• Loni Nicole Koski
• Kristin Koskinen
• Kern A. Kostenko, CRNA
• Yuliya Kostyuchenko, CPHT
• Sridivya Kosuri, MD

• Family Medicine Physician in Kennewick, WA
• Providers in Kennewick, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.