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MARK A. CASILLAS JR. M.D.
NPI 1245458082
Surgery in Knoxville, TN

Active since April 24, 2007PECOS EnrolledAccepts Medicare Assignment
95.69/100
CMS Quality Rating
1934 ALCOA HIGHWAY, BLDG D, SUITE 370, KNOXVILLE, TN 37920(865) 305-5335(865) 305-8840 Get Directions Write a Review

NPPES record last updated: February 4, 2014. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mark A. Casillas Jr. M.d. NPPES

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

MARK A. CASILLAS JR. M.D. (NPI 1245458082) is an individual surgery provider in Knoxville, Tennessee, licensed in Rhode Island (LP00968) and active in the NPI registry since April 2007. He is enrolled in Medicare PECOS, is affiliated with University Health System, Inc, and is a graduate of Other (2006).

NPPES Registry Identity

NPI1245458082
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameMARK A. CASILLAS JR.Credential: M.D.
Location Address1934 ALCOA HIGHWAY, BLDG D, SUITE 370Knoxville, TN 37920
Mailing Address1934 Alcoa Highway, Bldg D, Suite 370Knoxville, TN 37920 · (865) 305-5335 · Fax (865) 305-8840
Phone(865) 305-5335
Fax(865) 305-8840
Sole ProprietorYes
Medical School CMSOtherGraduated 2006
Enumeration DateApril 24, 2007
Last NPPES UpdateFebruary 4, 2014
✔ NPI 1245458082 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in RI · LP00968
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.

Also ListedColon & Rectal SurgeryTaxonomy 208C00000X · License 48676 (TN)
1934 ALCOA HIGHWAY, Knoxville, TN 37920
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Accepted Insurance

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

Mark A. Casillas Jr. 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 ID7012165988
PECOS Enrollment IDI20120918000677
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 10

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.

Diagnostic exam of anus using an endoscope 46600
This procedure involves using a thin, flexible instrument called an endoscope to examine the anal area. It helps detect any abnormal conditions or issues. It's a safe, routine exam performed by a healthcare professional.
55 services52 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.
45 services40 patients
Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery 45384
This procedure involves using a flexible tube with a camera, called an endoscope, to view the large intestine. If any abnormal growths or polyps are found, they are removed with an electrically-heated instrument. This is a common way to prevent bowel issues.
36 services34 patients
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.
36 services36 patients
Diagnostic exam of rectum and lower large bowel using an endoscope 45300
This procedure, known as a sigmoidoscopy, involves using a thin, flexible instrument called an endoscope to examine your lower large bowel and rectum. This helps in identifying any abnormalities or issues that could affect your digestive health.
21 services20 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.
21 services21 patients

Hospital Affiliations CMS Care Compare

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

University Health System, Inc

Acute Care Hospitals · Knoxville, TN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number440015
Location1924 Alcoa HighwayKnoxville, TN 37920 · Knox County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37920 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.

95.69/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality85.28
Promoting Interoperability100
Improvement Activities40

Reported Quality Measures

Appropriate indication for colonoscopy
Percentage of colonoscopy procedures performed for an indication that is included in a published standard list of appropriate indications and the indication is documented
82%95 patients3/55-star benchmark: 99%
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.

Referred Medical Equipment & Supplies CMS DME claims 8

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each A4385
DME-Orthotic Devices · category DF010N
2 suppliers49 claims1,370 services$4.45 avg. paid by Medicare
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce A4394
DME-Orthotic Devices · category DF010N
2 suppliers27 claims845 services$2.21 avg. paid by Medicare
Ostomy skin barrier, pectin-based, paste, per ounce A4406
DME-Orthotic Devices · category DF010N
2 suppliers11 claims84 services$4.81 avg. paid by Medicare
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each A4407
DME-Orthotic Devices · category DF010N
2 suppliers35 claims1,100 services$7.73 avg. paid by Medicare
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each A4409
DME-Orthotic Devices · category DF010N
2 suppliers17 claims520 services$4.74 avg. paid by Medicare
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each A4425
DME-Orthotic Devices · category DF010N
3 suppliers33 claims980 services$3.41 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 2

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

UNIVERSITY AMBULATORY SURGICAL CENTER
Clinic/Center (Ambulatory Surgical)
1934 ALCOA HIGHWAY, BLDG D SUITE 170
KNOXVILLE, TN 37920
Knox County (865) 305-8585
DR. NICOLE KISSANE LEE MD
Surgery
1934 ALCOA HIGHWAY, SUITE D-285
KNOXVILLE, TN 37920
Knox County (865) 305-9620

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 Casillas's NPI number?

The NPI number for Mark Casillas is 1245458082. It was assigned to this individual provider in the NPPES registry on April 24, 2007.

Where is Mark Casillas located?

Mark Casillas practices at 1934 Alcoa Highway Bldg D, Suite 370, Knoxville, TN 37920. The listed phone number is (865) 305-5335.

What is Mark Casillas's specialty?

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

Is Mark Casillas enrolled in Medicare?

Yes. Mark Casillas 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.

What insurance does Mark Casillas accept?

Health plans from BlueCross BlueShield of Tennessee and UnitedHealthcare list Mark Casillas 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 Casillas affiliated with any hospitals?

According to CMS data, Mark Casillas is affiliated with University Health System, Inc.

When was this NPI record last updated?

The NPPES record for Mark Casillas was last updated on February 4, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.