Mark Fesenmyer, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

01072085A Issued in IN

Practice address

8895 Broadway
Merrillville, IN 46410-7037

Phone

(219) 738-2081

Fax

(219) 736-4658

NPI assigned

Feb 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IN

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

Gastroenterology

Education

Indiana University School of Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Care Network IncGroup PAC ID 3678737012, 378 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Mary Medical Center Inc Hospital, Hobart, IN, CCN 150034
• St Catherine Hospital Inc Hospital, East Chicago, IN, CCN 150008
• Community Hospital Hospital, Munster, IN, CCN 150125
• Powers Health Rehabilitation Center Inpatient rehabilitation facility, Crown Point, IN, CCN 153045

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mfesenmyer40380@ssdirect.comhs.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Community Care Network Inc

  dba Powers Health Medical Group

  • Family Medicine Physician
  • Saint John, IN
  • NPI 1457610487
  Medicare reassignment Care Compare group NPD

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

• Community Stroke and Rehabilitation Center Inc

  dba Powers Health Rehabilitation Center

  • Rehabilitation Hospital
  • Crown Point, IN
  • NPI 1801301437

  Inpatient rehabilitation facility

  Care Compare affiliation
• Munster Medical Research Foundation Inc

  dba Community Hospital

  • General Acute Care Hospital
  • Munster, IN
  • NPI 1003918210
  Care Compare affiliation
• St Catherine Hospital Inc

  • General Acute Care Hospital
  • East Chicago, IN
  • NPI 1689776882
  Care Compare affiliation
• St Mary Medical Center Inc

  • General Acute Care Hospital
  • Hobart, IN
  • NPI 1558463745
  Care Compare affiliation
• St Mary Medical Center Inc

  dba St Mary Wound Clinic

  • General Acute Care Hospital
  • Hobart, IN
  • NPI 1962504175
  Care Compare affiliation

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

{
    "created_epoch": "1140393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588636800000",
    "number": "1992770390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8895 BROADWAY",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464107037",
            "telephone_number": "219-738-2081",
            "fax_number": "219-736-4658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8895 BROADWAY",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464107037",
            "telephone_number": "219-738-2081",
            "fax_number": "219-736-4658"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7835 Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "Hobart",
            "state": "IN",
            "postal_code": "463426665",
            "country_code": "US",
            "telephone_number": "219-947-6795",
            "fax_number": "219-703-6896",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3800 Saint Mary Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Valparaiso",
            "state": "IN",
            "postal_code": "463833986",
            "country_code": "US",
            "telephone_number": "219-947-6795",
            "fax_number": "219-703-6896",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FESENMYER",
        "first_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-20",
        "last_updated": "2020-05-05",
        "certification_date": "2020-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036105597",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IN",
            "license": "01072085A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000804383",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036105597",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201131780A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gabriella Fedro
• Rachel Fehland
• Carole Ann Feist
• Omar H Ferrario, PT
• Carrie Ferrell
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• Jeremy Ryan Fields
• Roshawnna Fields
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• First Impressions Optometric Associates, LLC

• Gastroenterology Physician in Merrillville, IN
• Providers in Merrillville, IN by specialty
• Gastroenterology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2020; 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.