MARK D FETTER MD PC
NPI 1124107206
Orthopaedic Surgery - Hand Surgery in Prescott, AZ
About Mark D Fetter Md Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARK D FETTER MD PC (NPI 1124107206) is a healthcare organization registered as a hand surgery in Prescott, Arizona and active in the NPI registry since November 2006. The organization lists Mark D Fetter, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mark D Fetter Md Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Mark D Fetter MD PC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 D Fetter MD PC's NPI number?
The NPI number for Mark D Fetter MD PC is 1124107206. It was assigned to this organization in the NPPES registry on November 2, 2006.
Where is Mark D Fetter MD PC located?
Mark D Fetter MD PC is located at 1615 Petroglyph Point Dr, Prescott, AZ 86301. The listed phone number is (480) 985-1093.
What is Mark D Fetter MD PC's specialty?
The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Hand Surgery, with taxonomy code 207XS0106X.
Is Mark D Fetter MD PC enrolled in Medicare?
Yes. Mark D Fetter MD PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Mark D Fetter MD PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Plastic and Reconstructive Surgery) reassigns their Medicare billing to Mark D Fetter MD PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Mark D Fetter MD PC was last updated on October 10, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.
# Mark D Fetter Md Pc · NPI 1124107206
Hand Surgery organization in Prescott, Arizona. Organization record, active in the CMS NPPES registry since November 2, 2006.
## Identity
- **NPI:** 1124107206 (Entity type: Organization)
- **Enumerated:** November 2, 2006
- **Primary specialty:** Orthopaedic Surgery - Hand Surgery · taxonomy 207XS0106X
- **Organization subpart:** No
- **Authorized official:** Mark Fetter, PRESIDENT
## Practice location
- **Address:** 1615 PETROGLYPH POINT DR, Prescott, AZ 86301-6539
- **Phone:** (480) 985-1093
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Plastic and Reconstructive Surgery) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 10, 2007
- **Other identifiers:** Medicare PIN Z65850 (AZ)
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Source: [NPI Profile](https://npiprofile.com/npi/1124107206) · Data from the CMS NPPES public registry.