Individual provider Active NPI

Mark Raymond Hightower, MD

  • Surgery Physician
  • Brainerd, MN
National Provider Identifier
1982959664
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
61942 Issued in MN
Practice address
2024 S 6TH St
Brainerd, MN 56401-4529
Phone
(218) 828-7101
NPI assigned
Jul 18, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 61942 MN Primary

Addresses

Primary practice location

2024 S 6TH St
Brainerd, MN 56401-4529

Mailing address

1702 University Dr S
Fargo, ND 58103-4940
Phone (701) 364-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20170706002226 MN Practitioner - General Surgery 9032488093 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Nebraska College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Josephs Medical CenterGroup PAC ID 8224948443, 238 clinicians

Practice addresses (Care Compare)

2024 S 6TH St
Brainerd, MN 56401-4529
Phone (218) 828-7100

Hospital & facility affiliations

  • Essentia Health St Joseph'S Medical Center Hospital, Brainerd, MN, CCN 240075

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy38
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux47
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61942MNMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Joseph'S Medical Center CurrentSince Aug 14, 2017 Accepting new patients
St. Joseph'S Medical Center CurrentSince Aug 14, 2017 Accepting new patients
St. Joseph'S Medical Center Current Accepting new patients

Locations

13114 Isle Dr
Baxter, MN 56425
Phone (218) 822-2400

523 N 3rd St
Brainerd, MN 56401
Phone (218) 828-7394

2024 S 6th St
Brainerd, MN 56401
Phone (218) 828-2880

400 E 3rd St
#2
Duluth, MN 55805
Phone (218) 786-8319

Organizations & group practices 3

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 10

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": "1342569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1982959664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 UNIVERSITY DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581034940",
            "telephone_number": "701-364-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2024 S 6TH ST",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564014529",
            "telephone_number": "218-828-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIGHTOWER",
        "first_name": "MARK",
        "middle_name": "RAYMOND",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-18",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MN",
            "license": "61942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brainerd, MN

Sources for this page

Verify at the official NPI Registry.