MARK S BIANCHI MD
NPI 1073574166
Otolaryngology in New Haven, CT

Active since March 29, 2006PECOS EnrolledAccepts Medicare Assignment
73.56/100
CMS Quality Rating
55 LOCK STREET, NEW HAVEN, CT 06511(203) 375-0050(203) 380-1616 Get Directions Write a Review

NPPES record last updated: February 28, 2012. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mark S Bianchi Md NPPES

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

MARK S BIANCHI MD (NPI 1073574166) is an individual otolaryngology provider in New Haven, Connecticut, licensed in Connecticut (035051) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS and is a graduate of Yale University School Of Medicine (1996).

NPPES Registry Identity

NPI1073574166
Entity TypeIndividualMale
Primary Taxonomy207Y00000X
Provider Legal NameMARK S BIANCHICredential: MD
Location Address55 LOCK STREETNew Haven, CT 06511
Mailing AddressPo Box 208237New Haven, CT 06520-8237 · (203) 375-0050 · Fax (203) 380-1616
Fax(203) 380-1616
Sole ProprietorNo
Medical School CMSYale University School Of MedicineGraduated 1996
Enumeration DateMarch 29, 2006
Last NPPES UpdateFebruary 28, 2012
NPI 1073574166 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207Y00000X
License Licensed in CT · 035051
Definition

An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.

Also ListedOtolaryngology · Plastic Surgery within the Head & NeckTaxonomy 207YX0007X · License 035051 (CT)
55 LOCK STREET, New Haven, CT 06511

Other Identifiers 4

Medicare PINC03962CT
Medicaid001350511CT
Medicare UPING24818
Medicare ID-Type Unspecified040000283

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

Mark S Bianchi 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 ID8022904622
PECOS Enrollment IDI20040223000174
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 8

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.
71 services71 patients
Removal of impacted ear wax 69210
Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.
66 services54 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.
44 services32 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
35 services34 patients
Diagnostic exam of voice box using a flexible endoscope 31575
This procedure involves a doctor examining your voice box using a flexible endoscope, a thin tube with a light and camera. It's inserted through your nose or mouth to visualize your throat area. It helps detect any abnormalities in your voice box, ensuring optimal vocal health.
30 services26 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.
20 services19 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06511 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
$138.84 typical visit price
range $60.82 – $183.10
Typical copayment $34.71 (range $15.20 – $45.77)
Most-billed visit code 99204
Established Patient
$75.55 typical visit price
range $19.76 – $149.26
Typical copayment $18.88 (range $4.94 – $37.31)
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.

73.56/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality75.84
Promoting Interoperability74
Improvement Activities40
Cost51.43

Other Providers at the Same Location NPPES 16

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

Radiology (Diagnostic Radiology)
55 LOCK STREET
NEW HAVEN, CT 06511
Advanced Practice Midwife
55 LOCK STREET
NEW HAVEN, CT 06511
Emergency Medicine
55 LOCK STREET
NEW HAVEN, CT 06511
Surgery
55 LOCK STREET
NEW HAVEN, CT 06511
Nurse Practitioner
55 LOCK STREET
NEW HAVEN, CT 06511
Psychiatry & Neurology (Psychiatry)
55 LOCK STREET
NEW HAVEN, CT 06511
Surgery
55 LOCK STREET
NEW HAVEN, CT 06511
Surgery
55 LOCK STREET
NEW HAVEN, CT 06511

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 Mark Bianchi's NPI number?

The NPI number for Mark Bianchi is 1073574166. It was assigned to this individual provider in the NPPES registry on March 29, 2006.

Where is Mark Bianchi located?

Mark Bianchi practices at 55 Lock Street, New Haven, CT 06511. The listed phone number is (203) 375-0050.

What is Mark Bianchi's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Is Mark Bianchi enrolled in Medicare?

Yes. Mark Bianchi is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Mark Bianchi was last updated on February 28, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.