Mark Stice

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

01089719A Issued in IN

Practice address

1120 W Michigan St # Cl285
Indianapolis, IN 46202-5209

Phone

(317) 278-0042

NPI assigned

Jun 17, 2019

Sex

Male

Sole proprietor

No

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

Enrolled in AZ

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

Specialty

Emergency Medicine

Education

University of Minnesota Medical School, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Banner-University Medical GroupGroup PAC ID 7719899871, 1,066 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner - University Medical Center Tucson Campus Hospital, Tucson, AZ, CCN 030064
• Banner-University Medical Center South Campus Hospital, Tucson, AZ, CCN 030111

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Banner-University Medical Group

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1508809427

  Emergency Medicine

  Medicare reassignment Care Compare group NPD
• Banner-University Medical Group

  • Nutrition Education Nutritionist
  • Tucson, AZ
  • NPI 1639842677
  NPD
• Banner-University Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Tucson, AZ
  • NPI 1922820935
  NPD
• Group Health, Inc.

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1710924683
  NPD (past)

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

• Banner - University Medical Center South Campus LLC

  • General Acute Care Hospital
  • Tucson, AZ
  • NPI 1558759498
  Care Compare affiliation
• Banner - University Medical Center South Campus LLC

  • Nutrition Education Nutritionist
  • Tucson, AZ
  • NPI 1922660182

  Hospital

  Care Compare affiliation
• Banner - University Medical Center Tucson Campus LLC

  • General Acute Care Hospital
  • Tucson, AZ
  • NPI 1265820179
  Care Compare affiliation
• Banner - University Medical Center Tucson Campus LLC

  • Nutrition Education Nutritionist
  • Tucson, AZ
  • NPI 1861102881

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1560729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1962062406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 W MICHIGAN ST # CL285",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 W MICHIGAN ST # CL285",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025209",
            "telephone_number": "317-278-0042"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "640 Jackson St",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551012502",
            "country_code": "US",
            "telephone_number": "651-254-3456",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STICE",
        "first_name": "MARK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-17",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01089719A",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Princeton Stewart, LCSW
• Reginald Stewart
• Shanette Stewart
• Tonya Renee Stewart, DDS
• Kathryn Stibley, MD
• Ellie Stichter, PHARMD
• Alyssa B. Stickley, DDS
• Robin Stickney, MD
• Skylar Stidam
• Heather Marie Stidd, PA-C

• Emergency Medicine Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Emergency Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; 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.