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MARK A PILKINTON M.D.
NPI 1184868481
Internal Medicine - Infectious Disease in Nashville, TN

Active since April 30, 2009PECOS EnrolledAccepts Medicare Assignment
1161 21ST AVE S, MCN A2200, NASHVILLE, TN 37232(615) 322-2035(615) 343-6160 Get Directions Write a Review

NPPES record last updated: February 28, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Feb 28, 2019, Jul 24, 2018, Aug 10, 2016 (3 updates tracked since 2016).

About Mark A Pilkinton M.d. NPPES

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

MARK A PILKINTON M.D. (NPI 1184868481) is an individual infectious disease provider in Nashville, Tennessee, licensed in Tennessee (50104) and active in the NPI registry since April 2009. He is enrolled in Medicare PECOS, is affiliated with Ascension Saint Thomas Hospital, and maintains a secondary practice location in Nashville.

NPPES Registry Identity

NPI1184868481
Entity TypeIndividualMale
Primary Taxonomy207RI0200X
Provider Legal NameMARK A PILKINTONCredential: M.D.
Location Address1161 21ST AVE S, MCN A2200Nashville, TN 37232
Mailing Address300 20th Ave N Ste 403Nashville, TN 37203-5180 · (615) 284-7224 · Fax (615) 284-7501
Phone(615) 322-2035
Fax(615) 343-6160
Sole ProprietorNo
Medical School CMSUniversity Of Illinois College Of Med (chi/peor/rock/chm-urb)Graduated 2009
Enumeration DateApril 30, 2009
Last NPPES UpdateFebruary 28, 20193 updates tracked since enumeration
✔ NPI 1184868481 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Infectious DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RI0200X
License✔ Licensed in TN · 50104
Definition
An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine.
Also ListedInternal MedicineTaxonomy 207R00000X · License 50104 (TN)
1161 21ST AVE S, Nashville, TN 37232
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Secondary Practice Location 1

Location 14220 Harding PikeNashville, TN 37205-2005 · Phone (615) 222-6977 · Fax (615) 222-5322

Other Identifiers 1

MedicaidQ008968TN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Cigna Healthcare, Oscar Health, Oscar Insurance Company.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mark A Pilkinton M.d. 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 ID9133348451
PECOS Enrollment IDI20140919000174
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.

Medicare Billing Reassignments

4

Medicare enrollment records show Mark Pilkinton reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Vanderbilt University Medical Center
0.2 mi
Internal Medicine
1301 22ND AVE S
Nashville, TN 37232
  • Reassigned Medicare billing, Tennessee enrollment
  • 4,711 clinicians in this Medicare group
NPI 1104202761 (615) 936-2000
Saint Thomas Medical Partners
0.6 mi
Clinical Neuropsychologist
2021 CHURCH ST, STE. 102
Nashville, TN 37203
  • Reassigned Medicare billing, Tennessee enrollment
  • 1,304 clinicians in this Medicare group
NPI 1558506980 (615) 284-7555
Beaman Physician Services, PC
2.7 mi
Hospitalist
4220 HARDING PIKE
Nashville, TN 37205
  • Reassigned Medicare billing, Tennessee enrollment
  • 97 clinicians in this Medicare group
NPI 1487342242 (615) 222-2111
Havely Springs Physician Services, PC
29 mi
Hospitalist
1700 MEDICAL CENTER PKWY
Murfreesboro, TN 37129
  • Reassigned Medicare billing, Tennessee enrollment
  • 116 clinicians in this Medicare group
NPI 1710494174 (615) 396-4100

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
291 services130 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
243 services115 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
107 services105 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.
84 services84 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.
48 services44 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
24 services24 patients

Hospital Affiliations CMS Care Compare 2

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

Ascension Saint Thomas Hospital

Acute Care Hospitals · Nashville, TN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number440082
Location4220 Harding Rd, PO Box 380Nashville, TN 37205 · Davidson County
Emergency services Birthing friendly

Henry County Medical Center

Acute Care Hospitals · Paris, TN
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number440132
Location301 Tyson AvParis, TN 38242 · Henry County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37232 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
$121.80 typical visit price
range $52.64 – $160.89
Typical copayment $30.45 (range $13.16 – $40.22)
Most-billed visit code 99204
Established Patient
$93.60 typical visit price
range $16.72 – $131.41
Typical copayment $23.40 (range $4.18 – $32.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

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

HOLLY VICTORIA CANNON FNP-C
Nurse Practitioner (Family)
1161 21ST AVE S
NASHVILLE, TN 37232
Davidson County (615) 936-0060
DR. EVAN ZEHR MD
Student in an Organized Health Care Education/Training Program
1161 21ST AVE S
NASHVILLE, TN 37232
Davidson County (615) 322-6943
DR. MEREDITH ANTONETTE MONSOUR MD
Student in an Organized Health Care Education/Training Program
1161 21ST AVE S
NASHVILLE, TN 37232
Davidson County (615) 322-6638
DR. PRIYA CORYN VERBIK MD
Student in an Organized Health Care Education/Training Program
1161 21ST AVE S
NASHVILLE, TN 37232
Davidson County (615) 343-4882
DAVID M ARONOFF MD
Internal Medicine (Infectious Disease)
1161 21ST AVE S, A-2200 MEDICAL CENTER NORTH
NASHVILLE, TN 37232
Davidson County (615) 322-8972
DR. CARI L MOTUZAS M.D.
Radiology (Neuroradiology)
1161 21ST AVE S, CCC-1121 MED CTR N, DEPARTMENT OF RADIOLOGY
NASHVILLE, TN 37232
Davidson County (615) 322-3780
JENNIFER LYNN REEVES AG-ACNP
Psychiatry & Neurology (Neurocritical Care)
1161 21ST AVE S
NASHVILLE, TN 37232
Davidson County (615) 343-4665
HEBAH AL KHATEEB MD
Student in an Organized Health Care Education/Training Program
1161 21ST AVE S
NASHVILLE, TN 37232
Davidson County (615) 343-4882

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 Pilkinton's NPI number?

The NPI number for Mark Pilkinton is 1184868481. It was assigned to this individual provider in the NPPES registry on April 30, 2009.

Where is Mark Pilkinton located?

Mark Pilkinton practices at 1161 21st Ave S Mcn A2200, Nashville, TN 37232. The listed phone number is (615) 322-2035.

What is Mark Pilkinton's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Infectious Disease, with taxonomy code 207RI0200X.

Is Mark Pilkinton enrolled in Medicare?

Yes. Mark Pilkinton 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.

Which organizations bill Medicare for Mark Pilkinton's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mark Pilkinton reassigns Medicare benefits to 4 organizations: Vanderbilt University Medical Center (Nashville, TN), Saint Thomas Medical Partners (Nashville, TN), Beaman Physician Services, PC (Nashville, TN) and Havely Springs Physician Services, PC (Murfreesboro, TN). Each 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 Mark Pilkinton's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Mark Pilkinton accept?

Health plans from Cigna Healthcare, Oscar Health and Oscar Insurance Company list Mark Pilkinton as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Mark Pilkinton affiliated with any hospitals?

According to CMS data, Mark Pilkinton is affiliated with Ascension Saint Thomas Hospital and Henry County Medical Center.

When was this NPI record last updated?

The NPPES record for Mark Pilkinton was last updated on February 28, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.