MARK TYE HAEBERLE NPI 1558650291

NPI Information

  • NPI: 1558650291
  • Provider Name: MARK TYE HAEBERLE
  • Classification: Dermatology - 207N00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 3810 SPRINGHURST BLVD
    SUITE 200
    LOUISVILLE, KY
    ZIP 40241
  • Phone: (502) 583-1749

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NPI Details

Mark Tye Haeberle is a dermatology in Louisville, KY with 14 years of experience. The provider is a dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. Mark Tye Haeberle NPI is 1558650291. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF LOUISVILLE SCHOOL OF MEDICINE
Graduation Year:2011

The provider's business location address is:

3810 SPRINGHURST BLVD
SUITE 200
LOUISVILLE, KY
ZIP 40241
Phone: (502) 583-1749
Fax: (502) 329-8184

The NPI 1558650291 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 following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Pathology examination of tissue using a microscope, intermediate complexity (HCPCS:88305)
  • Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks (HCPCS:17311)
  • Destruction of precancer skin growth, 2-14 growths (HCPCS:17003)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks (HCPCS:17312)
  • Destruction of precancer skin growth, 1 growth (HCPCS:17000)
  • Biopsy of related skin growth, first growth (HCPCS:11102)
  • Special stained specimen slides to examine tissue, each additional procedure (HCPCS:88341)
  • Established patient office or other outpatient visit, 10-19 minutes (HCPCS:99212)
  • Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.1-30.0 sq cm (HCPCS:14041)
  • Special stained specimen slides to examine tissue, initial procedure (HCPCS:88342)
  • Destruction of skin growth, 1-14 growths (HCPCS:17110)
  • Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks (HCPCS:17313)
  • Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm (HCPCS:13132)
  • Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less (HCPCS:14060)
  • Biopsy of related skin growth, each additional growth (HCPCS:11103)
  • Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm (HCPCS:12032)
  • Strapping, unna boot (HCPCS:29580)
  • Pathology examination of tissue using a microscope, moderately low complexity (HCPCS:88304)
  • Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 7.6-12.5 cm (HCPCS:12034)
  • Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm (HCPCS:13152)
  • New patient office or other outpatient visit, 30-44 minutes (HCPCS:99203)
  • Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm (HCPCS:14061)
  • Complicated repair of wound of scalp, arms, or legs, 2.6-7.5 cm (HCPCS:13121)
  • Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.6-5.0 cm (HCPCS:12052)
  • Repair of wound by transferring skin, 30.1-60.0 sq cm (HCPCS:14301)
  • Full thickness skin graft to nose, ears, eyelids, or lips, 20.0 sq cm or less (HCPCS:15260)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 5.1-7.5 cm (HCPCS:12053)
  • Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.0 sq cm or less (HCPCS:14040)
  • Biopsy of ear (HCPCS:69100)
  • Special stained specimen slides to identify organisms including interpretation and report (HCPCS:88312)
  • Removal and microscopic exam of growth of trunk, arms, or legs, each additional stage, 1-5 tissue blocks (HCPCS:17314)
  • Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm (HCPCS:12042)
  • New patient office or other outpatient visit, 15-29 minutes (HCPCS:99202)
  • Complicated repair of wound of scalp, arms, or legs, each additional 5.0 cm or less (HCPCS:13122)
  • Removal of noncancer skin growth of body, arms, or legs, 2.1-3.0 cm (HCPCS:11403)
  • Pathology examination of specimen during surgery, first tissue block (HCPCS:88331)
  • Melanoma (skin cancer) excision (HCPCS:NAN03)

The enumeration date for this NPI number is 4/4/2011 and was last updated on 7/17/2018.

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
1207N00000XDermatology47890KENTUCKYYes

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 Other Provider Identifier Issuer
17100215390MEDICAIDKENTUCKY

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: 3/30/2025

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