Individual provider Active NPI

Mark Correa, M.D.

  • Dermatology Physician
  • Austin, TX
National Provider Identifier
1962864488
Registry record updated Jun 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
S5147 Issued in TX
Practice address
4419 Frontier TRL Ste 110
Austin, TX 78745-1567
Phone
(512) 444-7208
Fax
(512) 444-2343
NPI assigned
Mar 23, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X S5147 TX Primary

Addresses

Primary practice location

4419 Frontier TRL Ste 110
Austin, TX 78745-1567

Mailing address

4419 Frontier TRL Ste 110
Austin, TX 78745-1567
Phone (512) 444-7208

Other practice location 1

1430 Tulane Ave # 8036
New Orleans, LA 70112-2632
Phone (504) 256-9619

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20200706003072 TX Practitioner - Dermatology 6002173416 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Florida College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Skin and Vein Center PLLCGroup PAC ID 9133429715, 8 clinicians

Practice addresses (Care Compare)

14008 Shadowglen Blvd
Suite 200
Manor, TX 78653-3406
Phone (512) 444-7208

211 B N FM
1626 Suite 1a
Buda, TX 78610-3859
Phone (737) 717-3244

249 Sportsplex Dr
Suite 210
Dripping Springs, TX 78620-2350
Phone (512) 444-7208

4419 Frontier TRL
Suite 110
Austin, TX 78745-1567

4544 S Lamar Blvd
Suite 640
Austin, TX 78745-1500
Phone (512) 444-7208

5625 Eiger Rd
Suite 105
Austin, TX 78735-8978
Phone (512) 444-7208

Merit-based Incentive Payment System (MIPS)

Final score
93.72 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
79.08

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision12
Removal of skin lesions1054
Removal or shaving of skin growth1-10
Skin biopsy278

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
S5147TXMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Skin and Vein Center PLLC Dermatology CurrentSince Jul 1, 2020 Accepting new patients
Southwest Skin & Cancer Clinic, P.a. Dermatology CurrentSince Apr 17, 2020 Accepting new patients

Locations

4419 Frontier Trl
Ste 110
Austin, TX 78745
Phone (512) 654-8100

4544 S Lamar Blvd
Ste 640
Austin, TX 78745

211B N FM 1626
Ste 1A
Buda, TX 78610
Phone (737) 717-3244

249 Sportsplex Dr
Ste 210
Dripping Springs, TX 78620

14008 Shadowglen Blvd
Ste 200
Manor, TX 78653

Interoperability endpoints

  • Direct secure messaging: drmac@southwestskin.emadirect.md

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1458691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593475200000",
    "number": "1962864488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4419 FRONTIER TRL STE 110",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787451567",
            "telephone_number": "512-444-7208",
            "fax_number": "512-444-2343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4419 FRONTIER TRL STE 110",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787451567",
            "telephone_number": "512-444-7208",
            "fax_number": "512-444-2343"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1430 Tulane Ave # 8036",
            "address_purpose": "LOCATION",
            "city": "New Orleans",
            "state": "LA",
            "postal_code": "701122632",
            "country_code": "US",
            "telephone_number": "504-256-9619",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORREA",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-23",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "S5147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.