MR. MARK ALAN FOX MD
NPI 1073526596
Surgery in Crossville, TN

Q: What is Mark Fox's NPI number?

The NPI number for Mark Fox is 1073526596. It was assigned to this individual provider in the NPPES registry on August 14, 2006.

Q: What is Mark Fox's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Q: When was this NPI record last updated?

The NPPES record for Mark Fox was last updated on June 7, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since August 14, 2006PECOS EnrolledAccepts Medicare Assignment

90.14/100

CMS Quality Rating

100 LANTANA RD, SUITE 202, CROSSVILLE, TN 38555(931) 484-5141(931) 484-5620 Get Directions Write a Review

NPPES record last updated: June 7, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Mr. Mark Alan Fox Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. MARK ALAN FOX MD (NPI 1073526596) is an individual surgery provider in Crossville, Tennessee, licensed in Tennessee (MD18036) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Cumberland Medical Center, and is a graduate of University Of Tennessee, Hsc, College Of Medicine (1986).

NPPES Registry Identity

NPI1073526596

Entity TypeIndividualMale

Primary Taxonomy208600000X

Provider Legal NameMR. MARK ALAN FOXCredential: MD

Location Address100 LANTANA RD, SUITE 202Crossville, TN 38555-1903

Mailing Address100 Lantana Rd, Suite 202Crossville, TN 38555-1903 · (931) 484-5141 · Fax (931) 484-5620

Phone(931) 484-5141

Fax(931) 484-5620

Sole ProprietorNo

Medical School CMSUniversity Of Tennessee, Hsc, College Of MedicineGraduated 1986

Enumeration DateAugust 14, 2006

Last NPPES UpdateJune 7, 2021

NPPES CertifiedJune 7, 2021

✔ NPI 1073526596 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208600000X

License✔ Licensed in TN · MD18036

Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

100 LANTANA RD, Crossville, TN 38555

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Other Identifiers 3

Other123414TN · Blue Cross

Other020015278Railroad Medicare

Medicaid3058927TN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of Tennessee.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Mark Alan Fox Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7113013715

PECOS Enrollment IDI20091201000002

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 15

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

50 services50 patients

Colorectal cancer screening; colonoscopy on individual at high risk G0105

Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.

49 services49 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

47 services47 patients

Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43235

This procedure, known as an upper endoscopy, involves inserting a thin, flexible tube with a camera down the throat to examine the esophagus, stomach, and upper small bowel. It helps diagnose conditions like ulcers or inflammation.

31 services31 patients

Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk G0121

Colorectal cancer screening, such as a colonoscopy, is a preventive measure to detect early signs of cancer in the large intestine. For individuals not at high risk, it's typically recommended at age 50. A small, flexible tube with a camera is used to examine your colon. It's a safe, effective way to catch issues early.

30 services30 patients

Repair of trapped groin hernia (5 years or older) 49507

A trapped groin hernia repair is a procedure to fix an issue where part of your intestine or fat pushes through a weak spot in your lower abdominal wall, causing discomfort. The surgery puts these back in place and strengthens the weak area to prevent recurrence.

29 services29 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

29 services27 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

28 services28 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

27 services25 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

23 services21 patients

Fluoroscopic guidance for insertion or removal of central vein access device 77001

Fluoroscopic guidance for central vein access device insertion or removal is a procedure where a special X-ray, called a fluoroscope, is used to help accurately place or remove a device in a central vein. This device aids in delivering medications or collecting blood samples.

17 services17 patients

Insertion of central venous tube with port (5 years or older) 36561

A central venous tube with port is a small, flexible tube inserted into a large vein, usually in the chest. It allows for easy administration of medication, fluids, or blood products over a long period. A port is attached under the skin for easy access. It's safe for individuals aged 5 and above.

16 services16 patients

Diagnostic exam of large bowel using a flexible endoscope 45378

This procedure, known as a colonoscopy, involves using a flexible tube with a light and camera to examine the large intestine. It helps detect any abnormalities such as polyps or inflammation. It's a standard procedure to ensure gut health.

15 services15 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

12 services12 patients

New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more 99202

This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.

11 services11 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Cumberland Medical Center

Acute Care Hospitals · Crossville, TN

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number440009

Location421 S Main StCrossville, TN 38555 · Cumberland County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 38555 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$81.53 typical visit price

range $52.64 – $160.89

Typical copayment $20.38 (range $13.16 – $40.22)

Most-billed visit code 99203

Established Patient

$66.01 typical visit price

range $16.72 – $131.41

Typical copayment $16.50 (range $4.18 – $32.85)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

90.14/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

93.34

Promoting Interoperability

100

Improvement Activities

Cost

73.81

Reported Quality Measures

Colorectal Cancer Screening

62%355 patients3/55-star benchmark: 88%

Controlling High Blood Pressure

78%138 patients4/55-star benchmark: 91%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

21%68 patients4/55-star benchmark: 91%

e-Prescribing

99%82 patients4/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

95%329 patients4/55-star benchmark: 100%

Preventive Care and Screening: Screening for Depression and Follow-Up Plan

88%317 patients4/55-star benchmark: 97%

Provide Patients Electronic Access to Their Health Information

96%222 patients4/55-star benchmark: 100%

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 2% · 351 patients

Patients totalRate: 1% · 351 patients

0%351 patients5/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. BRUCE CORWYN RAFFEL MD

Surgery (Plastic and Reconstructive Surgery)