DR. MARK S MASSIE (NPI# 1538110648) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538110648 |
| Entity Type | Individual |
| Full Name | DR. MARK S MASSIE |
| Credential | DPM |
| Practice Address |
15644 Madison Ave 106 Lakewood OH 44107-5622 |
| Mailing Address |
Po Box 40450 Bay Village OH 44140-0450 |
| Practice Telephone | 2162212445 |
| Practice Fax Number | 2162215891 |
| Mailing Telephone | 4408714700 |
| Mailing Fax Number | 4408714702 |
| Enumeration Date | 2006-05-13 |
| Last Update Date | 2010-07-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 3600307M | OH | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2066204 | 05 | |
| OH | MEDICARE RAILROAD PIN | P00301287 | 01 |
| Street Address |
15644 MADISON AVE 106 |
| City | LAKEWOOD |
| State | OH |
| Zip Code | 44107-5622 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679574156 | West Side Cardiothoracic Surgeons, Inc. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 15644 Madison Ave, Suite #202, Lakewood, OH 44107-5622 | 2005-08-09 |
| 1215311931 | Sara Perry | Chiropractor | 15644 Madison Ave, Ste 213, Lakewood, OH 44107-5622 | 2015-07-13 |
| 1770962565 | Royalty Care Services LLC | Hospice Care, Community Based | 15644 Madison Ave, Ste 207, Lakewood, OH 44107-5622 | 2015-05-26 |
| 1205245669 | Donna Rakerd | Social Worker | 15644 Madison Ave, Lakewood, OH 44107-5622 | 2014-08-10 |
| 1104240019 | Premier Physicians Centers, Inc. | Durable Medical Equipment & Medical Supplies | 15644 Madison Ave, Suite 213, Lakewood, OH 44107-5622 | 2014-02-12 |
| 1538334545 | Outreach Professional Services, Inc. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 15644 Madison Ave, Suite 202, Lakewood, OH 44107-5622 | 2008-04-30 |
| 1396928883 | Premier Physicians Centers, Inc | Clinical Medical Laboratory | 15644 Madison Ave, Suite 218, Lakewood, OH 44107-5622 | 2007-12-07 |
| 1053591321 | Dr. Mark S. Massie, L.L.C. | Podiatrist | 15644 Madison Ave, Lakewood, OH 44107-5622 | 2007-11-05 |
| 1053509869 | Enrique Cotes | Pathology | 15644 Madison Ave, Suite 218, Lakewood, OH 44107-5622 | 2007-10-05 |
| 1629149307 | Cynthia Ann Walsh | Social Worker | 15644 Madison Ave, Suite 108, Lakewood, OH 44107-5622 | 2006-11-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326522210 | Lawrence M Roth | Social Worker | 14701 Detroit Ave Ste 363, Lakewood, OH 44107 | 2018-09-18 |
| 1376065730 | Fareeha Khan | Internal Medicine | 12540 Edgewater Drive, Apt 411, Lakewood, OH 44107 | 2017-07-07 |
| 1912433756 | Julie Ann Foucher-urcuyo | Family Medicine | 14601 Detroit Ave, Fl 2, Lakewood, OH 44107 | 2017-05-11 |
| 1225563661 | Elizabeth Ann Rainbolt | Family Medicine | 14601 Detroit Ave Fl 2, Lakewood, OH 44107 | 2017-04-24 |
| 1255882551 | Kristen Murray | Dietitian, Registered | 14900 Detroit Ave Ste 207, Lakewood, OH 44107 | 2016-10-21 |
| 1265828131 | David Thomas Jonke | Dentist | 15640 Madison Ave., Lakewood, OH 44107 | 2015-04-08 |
| 1760885941 | Debra Watkins | Home Health Aide | 1510 Newman Ave Apt 406, Lakewood, OH 44107 | 2014-10-02 |
| 1396155198 | Monica M Owen | Occupational Therapist | 9200 Biddulph Rd., Brooklyn, OH 44107 | 2014-05-01 |
| 1730512229 | Marsha Elaine Favors | Licensed Practical Nurse | 1448 Lakeland Ave, Lakewood, OH 44107 | 2013-08-20 |
| 1508130006 | Ruth Rachel Raciniewski | Counselor | 15200 Madison Avenue, Lakewood, OH 44107 | 2012-03-01 |
| Find all providers in zip 44107 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225646979 | New West Physicians, P.C. | Podiatrist | 1536 Cole Blvd # 4-250, Lakewood, CO 80401-3413 | 2020-07-20 |
| 1326571308 | Randi Jean Keefe | Podiatrist | 1312 Donald Ave, Lakewood, OH 44107-2851 | 2017-04-06 |
| 1043662158 | Kristina Eunjeong Chang | Podiatrist | 3700 E South Street, Lakewood, CA 90805 | 2016-07-13 |
| 1790931087 | Paul H Eisenberg, Dpm Inc | Podiatrist | 14900 Detroit Ave, Lakewood, OH 44107-3923 | 2008-08-18 |
| 1225255086 | Kurt Gustavson | Podiatrist | 6216 Whisper Ln Sw, Lakewood, WA 98499-1139 | 2007-04-20 |
| 1689719619 | Rosa Montemayor Dpm PC | Podiatrist | 9255 W Alameda Ave Ste F, Lakewood, CO 80226-2802 | 2007-02-20 |
| 1235279993 | Michael Joseph Beauclair | Podiatrist | 1415 Blossom Park Ave, Lakewood, OH 44107-4401 | 2007-02-08 |
| 1568576528 | James F Eggold | Podiatrist | 5445 Del Amo Blvd Ste 102, Lakewood, CA 90712-2761 | 2006-08-18 |
| 1154385284 | Paul Thomas Voegeli Jr. | Podiatrist | 165 South Union Boulevard, Suite 322, Lakewood, CO 80228-2211 | 2006-04-14 |
| 1619954302 | Ronald J Lancz | Podiatrist | 105 River Avenue, Building B Suite #303, Lakewood, NJ 08701 | 2005-12-23 |
| Find all providers in LAKEWOOD | ||||
Please comment or provide details below to improve the information on DR. MARK S MASSIE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.