Individual provider Active NPI

Mark L. Gates, MD

  • Diagnostic Radiology Physician
  • Cape Girardeau, MO
National Provider Identifier
1992711006
Registry record updated Sep 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
107967 Issued in MO
Practice address
70 Doctors Park
Cape Girardeau, MO 63703-4928
Phone
(573) 334-6071
Fax
(573) 334-4739
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Radiology Physician 2085N0904X 107967 MO
Diagnostic Radiology Physician 2085R0202X 107967 MO Primary

Addresses

Primary practice location

70 Doctors Park
Cape Girardeau, MO 63703-4928

Mailing address

70 Doctors Park
Cape Girardeau, MO 63703-4928
Phone (573) 334-6071

Other identifiers 1

IdentifierTypeStateIssuer
207979006MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL, KY3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20080829000374 MO Practitioner - Diagnostic Radiology 3678532017 Reassigns benefits to 3 organizations
I20100928000579 IL Practitioner - Diagnostic Radiology 3678532017 Reassigns benefits to 1 organization
I20230705002159 KY Practitioner - Diagnostic Radiology 3678532017 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Creighton University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cape Radiology Group PCGroup PAC ID 9830093236, 54 clinicians
Mercy Hospital PerryGroup PAC ID 1153777826, 115 clinicians

Practice addresses (Care Compare)

1530 Lone Oak Rd
Paducah, KY 42003-7901
Phone (270) 444-2444

434 N W St
Perryville, MO 63775-1359
Phone (573) 547-2536

517 N Main St
Anna, IL 62906-1668
Phone (618) 833-4511

70 Doctors Park
Cape Girardeau, MO 63703-4928
Phone (573) 334-6071

Hospital & facility affiliations

  • Saint Francis Medical Center Hospital, Cape Girardeau, MO, CCN 260183
  • Poplar Bluff Regional Medical Center Hospital, Poplar Bluff, MO, CCN 260119
  • Memorial Hospital of Carbondale Hospital, Carbondale, IL, CCN 140164
  • Mercy Health - Lourdes Hospital Hospital, Paducah, KY, CCN 180102
  • Mercy Hospital Southeast Hospital, Cape Girardeau, MO, CCN 260110

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
107967MOMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Perry CurrentSince Oct 1, 2023 Accepting new patients
Mercy Hospital Perry Diagnostic Radiology CurrentSince Oct 1, 2023 Accepting new patients
Rolla Radiology Group, LLC Diagnostic Radiology Past Accepting new patients
Bluff Radiology Group, LLC Diagnostic Radiology Past Accepting new patients
Texas Tech University Health Sciences Center Odessa Past Accepting new patients

Locations

434 N West St
Perryville, MO 63775
Phone (573) 547-2530

Organizations & group practices 6

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 7

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1992711006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 DOCTORS PARK",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637034928",
            "telephone_number": "573-334-6071",
            "fax_number": "573-334-4739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 DOCTORS PARK",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637034928",
            "telephone_number": "573-334-6071",
            "fax_number": "573-334-4739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATES",
        "first_name": "MARK",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "MO",
            "license": "107967",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "107967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207979006",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.