Individual provider Active NPI

Mark Anthony Runfola, M.D.

  • Surgery Physician
  • Mesa, AZ
National Provider Identifier
1972509016
Registry record updated Feb 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
28152 Issued in AZ
Practice address
2945 S Dobson Rd
Mesa, AZ 85202-7980
Phone
(480) 969-4138
Fax
(480) 969-0630
NPI assigned
Jun 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 28152 AZ Primary

Addresses

Primary practice location

2945 S Dobson Rd
Mesa, AZ 85202-7980

Mailing address

2945 S Dobson Rd
Mesa, AZ 85202-7980
Phone (480) 969-4138

Other identifiers 1

IdentifierTypeStateIssuer
536360MedicaidAZ

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040309000500 AZ Practitioner - General SurgeryPractitioner - Surgical Oncology 8426946682 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Surgical Oncology
Education
State University of New York at Buffalo School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arizona Advanced Surgery LLCGroup PAC ID 0547690166, 93 clinicians

Practice addresses (Care Compare)

2320 N 3Rd St
Phoenix, AZ 85004-1303
Phone (602) 340-0201

2945 S Dobson Rd
Mesa, AZ 85202-7941
Phone (480) 969-4138

Hospital & facility affiliations

  • Chandler Regional Medical Center Hospital, Chandler, AZ, CCN 030036
  • Banner Desert Medical Center Hospital, Mesa, AZ, CCN 030065

Merit-based Incentive Payment System (MIPS)

Final score
94.9 of 100Reported as group
Promoting interoperability
94
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision61
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28152AZMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Advanced Surgery LLC Surgery CurrentSince Apr 1, 2020 Accepting new patients

Locations

2945 S Dobson Rd
#2320N
Mesa, AZ 85202

1400 S Dobson Rd
Mesa, AZ 85202
Phone (480) 412-3000

2945 S Dobson Rd
Mesa, AZ 85202
Phone (480) 699-2508

2320 N 3rd St
Phoenix, AZ 85004
Phone (602) 258-3262

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IGJBCD

Organizations & group practices 1

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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519776000000",
    "number": "1972509016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2945 S DOBSON RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852027980",
            "telephone_number": "480-969-4138",
            "fax_number": "480-969-0630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2945 S DOBSON RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852027980",
            "telephone_number": "480-969-4138",
            "fax_number": "480-969-0630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUNFOLA",
        "first_name": "MARK",
        "middle_name": "ANTHONY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2018-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "28152",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "536360",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.