DR. KELLY MARK PSYD
NPI 1043561285
Psychologist in Bellevue, WA
About Dr. Kelly Mark Psyd NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. KELLY MARK PSYD (NPI 1043561285) is an individual psychologist in Bellevue, Washington, licensed in Washington (PY60781335) and active in the NPI registry since September 2012. She has opted out of Medicare through January 5, 2027 and remains eligible to order and refer and maintains 2 additional practice locations.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Locations 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Dr. Kelly Mark Psyd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 5, 2019 through January 5, 2027.
Other Providers at the Same Location NPPES 4
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
BELLEVUE, WA 98004
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kelly Mark's NPI number?
The NPI number for Kelly Mark is 1043561285. It was assigned to this individual provider in the NPPES registry on September 27, 2012.
Where is Kelly Mark located?
Kelly Mark practices at 330 112th Ave NE Ste 302, Bellevue, WA 98004. The listed phone number is (206) 853-2409.
What is Kelly Mark's specialty?
The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.
Is Kelly Mark enrolled in Medicare?
No. Kelly Mark has opted out of Medicare through January 5, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.
When was this NPI record last updated?
The NPPES record for Kelly Mark was last updated on May 24, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.