Individual provider Active NPI

Mark E. Choquette, M.D.

  • Emergency Medicine Physician
  • Dothan, AL
National Provider Identifier
1992777619
Registry record updated Nov 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
14035 Issued in AL
Practice address
1500 Ross Clark Cir
Dothan, AL 36301-4754
Phone
(334) 793-2663
Fax
(334) 836-2247
NPI assigned
Feb 6, 2006
Last updated
Nov 20, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 14035 AL Primary

Addresses

Primary practice location

1500 Ross Clark Cir
Dothan, AL 36301-4754

Mailing address

PO Box 729
Dothan, AL 36302-0729
Phone (334) 793-2663

Other identifiers 3

IdentifierTypeStateIssuer
009988705MedicaidAL
000619286EMedicaidGA
515-27360OtherALBCBS OF AL 1500 RCC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20110118000904 AL Practitioner - Emergency Medicine 5597726042 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Louisiana State University School of Medicine in New Orleans, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
S.B.J.S. PCGroup PAC ID 8527043421, 39 clinicians

Practice addresses (Care Compare)

1500 Ross Clark Cir
Dothan, AL 36301-4754
Phone (334) 793-2663

345 Healthwest Dr
Dothan, AL 36303-2053
Phone (334) 793-2663

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14035ALMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SBJS PC Emergency Medicine CurrentSince Apr 11, 2005 Accepting new patients
S.B.J.S. PC CurrentSince Apr 11, 2005 Accepting new patients
Emcare Physician Providers, Inc. Emergency Medicine Past Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients
United Emergency Services, Inc. Emergency Medicine Past Accepting new patients

Locations

1500 Ross Clark Cir
Dothan, AL 36301
Phone (334) 793-2663

820 W Washington St
Eufaula, AL 36027
Phone (334) 687-5761

Interoperability endpoints

  • Direct secure messaging: mark.choquette.1@15455.direct.athenahealth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416441600000",
    "number": "1992777619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 729",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363020729",
            "telephone_number": "334-793-2663",
            "fax_number": "334-836-2247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 ROSS CLARK CIR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363014754",
            "telephone_number": "334-793-2663",
            "fax_number": "334-836-2247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOQUETTE",
        "first_name": "MARK",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-06",
        "last_updated": "2014-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AL",
            "license": "14035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009988705",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000619286E",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF AL  1500 RCC",
            "identifier": "515-27360",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.