MARK V MAZZIOTTI MD NPI 1306809918

NPI Information

NPI: 1306809918
Provider Name: MARK V MAZZIOTTI, MD
Classification: Surgery - 2086S0120X
Entity Type: Individual

Specialization: Pediatric Surgery

PECOS Registration: Yes

Address:
202 CONWAY DR STE 200
KALISPELL, MT
ZIP 59901
Phone: (406) 758-7490
Get Directions

Mark V Mazziotti, MD is a pediatric surgery surgery in Kalispell, MT with 31 years of experience. The provider is a surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. Mark V Mazziotti, MD NPI is 1306809918. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

202 CONWAY DR STE 200
KALISPELL, MT
ZIP 59901-153
Phone: (406) 758-7490
Fax: (406) 758-7080

The NPI 1306809918 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/7/2006 and was last updated on 9/8/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2086S0120X	Surgery	Pediatric Surgery	MED-PHYS-LIC-100462	MONTANA	No
2	2086S0120X	Surgery	Pediatric Surgery	30540	OKLAHOMA	No
3	2086S0120X	Surgery	Pediatric Surgery	L2453	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	200122410A	MEDICAID	OKLAHOMA
2	112545202	MEDICAID	TEXAS
3	154947902	MEDICAID	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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