Mark D Erickstad, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

H2362 Issued in TX

Practice address

802 Medical Dr
Suite 400
Longview, TX 75605-5100

Phone

(903) 757-7871

Fax

(903) 753-2479

NPI assigned

Mar 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Urology

Education

University of Texas Southwestern Medical School at Dallas, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Texas Oncology PAGroup PAC ID 5395658934, 1,001 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Longview Regional Medical Center Hospital, Longview, TX, CCN 450702
• Titus Regional Medical Center Hospital, Mount Pleasant, TX, CCN 450080
• Ut Health East Texas Carthage Hospital Hospital, Carthage, TX, CCN 450210

Merit-based Incentive Payment System (MIPS)

Final score

85.12 of 100Reported as apm

Quality

67.48

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: markerickstad@tusdfw.medalliesdirect.net
• FHIR API: https://api.platform.athenahealth.com/23550/brand/1/csg/1/fhir/r4

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.

• Texas Oncology PA

  • Medical Oncology Physician
  • El Paso, TX
  • NPI 1811944101

  Urology

  Medicare reassignment Care Compare group NPD
• Regional Clinics of Longview

  • Internal Medicine Physician
  • Longview, TX
  • NPI 1407047863

  Urology

  Medicare reassignment NPD
• Texas Oncology PA

  • Medical Oncology Physician
  • Dallas, TX
  • NPI 1003083445
  NPD
• Texas Oncology PA

  • Medical Oncology Physician
  • Webster, TX
  • NPI 1821265265
  NPD
• Texas Oncology PA

  • Medical Oncology Physician
  • Pearland, TX
  • NPI 1912174350
  NPD
• Diagnostic Clinic of Longview PA

  • Internal Medicine Physician
  • Longview, TX
  • NPI 1386638468
  NPD (past)

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

• Carthage Hospital, LLC

  • General Acute Care Hospital
  • Carthage, TX
  • NPI 1538667035
  Care Compare affiliation
• Longview Medical Center LP

  dba Longview Regional Medical Center

  • General Acute Care Hospital
  • Longview, TX
  • NPI 1528026267
  Care Compare affiliation
• Titus County Hospital District

  dba Titus Regional Medical Center

  • Multi-Specialty Clinic/Center
  • Mount Pleasant, TX
  • NPI 1063548881

  Hospital

  Care Compare affiliation
• Titus County Hospital District

  dba Titus Regional Medical Center

  • General Acute Care Hospital
  • Mt Pleasant, TX
  • NPI 1174526529
  Care Compare affiliation

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

{
    "created_epoch": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431907200000",
    "number": "1972570307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 847176",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752847176",
            "telephone_number": "903-237-1800",
            "fax_number": "903-237-1810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 MEDICAL DR",
            "address_2": "SUITE 400",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756055100",
            "telephone_number": "903-757-7871",
            "fax_number": "903-753-2479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSTAD",
        "first_name": "MARK",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-03",
        "last_updated": "2015-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "TX",
            "license": "H2362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127746908",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00417180",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Engdayehu, RN FNP
• Baylie Michele English
• Casey Renee English, APRN-CNP
• Kristen Hibbs Erickstad, MD
• Landon Taylor Erickstad, MD
• Nils Siegfried Erikson, M.D.
• Renee Elizabeth Ernst, NP-C
• Stacey D Ervin, FNP
• David Randolph Erwin, M.D.
• Esc IV LP (Brookdale Longview)

• Urology Physician in Longview, TX
• Providers in Longview, TX by specialty
• Urology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2015; 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.