MARK S ROBBINS MD
NPI 1265442206
Internal Medicine - Hematology & Oncology in Cranston, RI

NPI Status: Active since August 09, 2006

Contact Information

1220 PONTIAC AVE
SUITE 101
CRANSTON, RI
ZIP 02920
Phone: (401) 943-4660

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Secondary Locations
Medicare Participation & PECOS Status
Areas of Expertise
Physician Visit Costs
Quality Reporting
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Internal Medicine
Hematology & Oncology
Accepts Insurance
PECOS Enrolled
Medicare Quality Reporting

About MARK ROBBINS

This page provides the complete NPI Profile along with additional information for Mark Robbins, an internist established in Cranston, Rhode Island with a medical specialization in Internal Medicine, focusing in hematology & oncology . The healthcare provider is registered in the NPI registry with number 1265442206 assigned on August 2006. The practitioner's primary taxonomy code is 207RH0003X with license number MD20594 (RI). The provider is registered as an individual and his NPI record was last updated April 2025.

NPI: 1265442206
Provider Name: MARK S ROBBINS MD
Other Name: MARK STANTON ROBBINS MD
Other Name Type: Other Name (5)
Gender: Male
Entity Type: Individual
Location Address: 1220 PONTIAC AVE SUITE 101 CRANSTON, RI 02920
Location Phone: (401) 943-4660
Mailing Address: 455 TOLL GATE RD PRC AND CREDENTIALING WARWICK, RI 02886
Mailing Phone: (401) 273-0641
Mailing Fax
Is Sole Proprietor?: No
Enumeration Date: 08-09-2006
Last Update Date: 04-17-2025
Code Navigator

An internist like Mark Robbins is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Location Map

Secondary Locations

455 Toll Gate Rd Hematology/Oncology
Warwick, RI 02886
(401) 732-5900

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Internal Medicine Hematology & Oncology
Taxonomy Code: 207RH0003X
Type: Allopathic & Osteopathic Physicians
License No.: MD20594
License State: RI
Taxonomy Description: An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Ambetter from Superior HealthPlan

Clear VALUE Silver - HMO
Complete VALUE Gold - HMO
Focused VALUE Silver - HMO
Focused VALUE Silver + Vision + Adult Dental - HMO
Standard Gold VALUE - HMO
Standard Silver VALUE - HMO
Standard Silver VALUE + Vision + Adult Dental - HMO

Ambetter Health

Complete VALUE Gold - HMO
Complete VALUE Silver - HMO
Elite VALUE Bronze - HMO
Focused VALUE Silver - HMO
Standard Expanded Bronze VALUE - HMO
Standard Gold VALUE - HMO
Standard Silver VALUE - HMO

Anthem Blue Cross and Blue Sheld

Anthem Bronze Preferred Blue PPO 5000/10%/8000 w/HSA - PPO
Anthem Bronze Preferred Blue PPO 5000/20%/8000 w/HSA - PPO
Anthem Bronze Preferred Blue PPO 6500/30%/9200 Value - PPO
Anthem Bronze Preferred Blue PPO 7000/50%/8000 w/HSA - PPO
Anthem Bronze Preferred Blue PPO 8500/50%/9200 - PPO
Anthem Gold Preferred Blue PPO 1000/20%/7500 - PPO
Anthem Gold Preferred Blue PPO 2000/0%/6500 RxD - PPO
Anthem Gold Preferred Blue PPO 2000/10%/4600 w/HSA - PPO
Anthem Gold Preferred Blue PPO 2000/10%/7500 - PPO
Anthem Gold Preferred Blue PPO 2000/20%/4600 w/HSA - PPO

Anthem Blue Cross and Blue Shield

Anthem Bronze Pathway X Enhanced 6000/35% HSA - HMO
Anthem Bronze Pathway X Enhanced 6500/40% ($0 Virtual PCP + $0 Select Drugs) - HMO
Anthem Bronze Pathway X Enhanced 7500/50% ($0 Virtual PCP + $0 Select Drugs) Standard - HMO
Anthem Catastrophic Pathway X Enhanced 9200/0% - HMO
Anthem Gold Pathway X Enhanced 1200/20% ($0 Virtual PCP + $0 Select Drugs) - HMO
Anthem Gold Pathway X Enhanced 1500/25% ($0 Virtual PCP + $0 Select Drugs) Standard - HMO
Anthem Gold Pathway X Enhanced 700/40% ($0 Virtual PCP + $0 Select Drugs) - HMO
Anthem Heart Healthy Bronze Pathway X Enhanced 6000/30% ($0 Virtual PCP + $0 Select Drugs) - HMO
Anthem Heart Healthy Silver Pathway X Enhanced 4000/0% ($0 Virtual PCP + $0 Select Drugs) - HMO
Anthem Silver Pathway X Enhanced 4500/20% HSA - HMO

Harvard Pilgrim Health Care

NH Local Choice HMO Bronze 8000 - HMO
NH Local Choice HMO Gold - HMO
NH Local Choice HMO Gold 1400 - HMO
NH Local Choice HMO HSA Bronze 6000 - HMO
NH Local Choice HMO Silver 3500 - HMO
NH Local Choice HMO Silver 5000 - HMO
NH Local HMO Bronze 7500 Standard - HMO
NH Local HMO Gold 1500 Standard - HMO
NH Local HMO Silver 5000 Standard - HMO

Molina Healthcare

Bronze 4 - HMO
Bronze 8 - HMO
Gold 1 - HMO
Gold 1 with Adult Vision Services - HMO
Gold 8 - HMO
Silver 1 - HMO
Silver 1 with Adult Vision Services - HMO
Silver 12 with First 4 Primary Care Visits Free - HMO
Silver 8 - HMO
Silver 9 - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Mark Robbins is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Administration of additional new drug or substance into vein, 1 hour or less
Administration of chemotherapy into vein, 1 hour or less
Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle
Blood test, comprehensive group of blood chemicals
Blood test, thyroid stimulating hormone (tsh)
Carcinoembryonic antigen (cea) protein level
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count
Cyanocobalamin (vitamin b-12) level
Drawing of blood for a medical problem
Erythropoietin (protein) level
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Established patient office or other outpatient visit, 40-54 minutes
Ferritin (blood protein) level
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries
Folic acid level, serum
Gammaglobulin (immune system protein) measurement
Haptoglobin (serum protein) level
Immunologic analysis for detection of tumor antigen, quantitative; ca 15-3
Immunologic analysis technique on serum (immunofixation)
Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less
Infusion into a vein for therapy, prevention, or diagnosis, additional sequential infusion, 1 hour or less
Infusion into a vein for therapy, prevention, or diagnosis, each additional hour
Injection of additional new drug or substance into vein
Injection of drug or substance into vein
Injection of drug or substance under skin or into muscle
Injection, denosumab, 1 mg
Injection, dexamethasone sodium phosphate, 1 mg
Injection, diphenhydramine hcl, up to 50 mg
Injection, epoetin alfa, (for non-esrd use), 1000 units
Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units
Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use)
Injection, methylprednisolone sodium succinate, up to 40 mg
Injection, palonosetron hcl, 25 mcg
Injection, pembrolizumab, 1 mg
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg
Insertion of needle into vein for collection of blood sample
Iron binding capacity
Iron level
Lactate dehydrogenase (enzyme) level
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml
Magnesium level
Measurement of immunoglobulin light chains
New patient office or other outpatient visit, 60-74 minutes
Nuclear medicine study from skull base to mid-thigh with ct scan
Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional
Psa (prostate specific antigen) measurement, total
Red blood count, automated test
Rheumatoid factor level
Testosterone (hormone) level, total

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 02920 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99205

Average New Patient Price $177.03
Minimum New Patient Price $58.57
Maximum New Patient Price $177.03

Average New Patient Copayment $44.25
Minimum New Patient Copayment $14.64
Maximum New Patient Copayment $44.25

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

Average Established Patient Price $103.1
Minimum Established Patient Price $18.92
Maximum Established Patient Price $144.38

Average Established Patient Copayment $25.77
Minimum Established Patient Copayment $4.73
Maximum Established Patient Copayment $36.09

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure	Performance	Number of Patients
Engagement of New Medicaid Patients and Follow-up	Yes	N/A
Seeing new and follow-up Medicaid patients in a timely manner, including individuals dually eligible for Medicaid and Medicare. A timely manner is defined as within 10 business days for this activity.
e-Prescribing	96%	1148
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Health Information Exchange	97%	62
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for at least one transition of care or referral.
Immunization Registry Reporting	Yes	N/A
The MIPS eligible clinician is in active engagement with a public health agency to submit immunization data.
Medication Reconciliation	96%	317
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
Patient-Specific Education	32%	1336
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical Record	Yes	N/A
• Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following: • Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care); • Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/or Provision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management.
Provide Patient Access	64%	1336
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information.
Secure Messaging	11%	1336
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period.
Security Risk Analysis	Yes	N/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
Specialized Registry Reporting	Yes	N/A
The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI.
Syndromic Surveillance Reporting	Yes	N/A
The MIPS eligible clinician is in active engagement with a public health agency to submit syndromic surveillance data. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_2_MULTI.

NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1	2	6	5	4	4	2	2	0	6
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	2	12	5	8	4	4	2	0
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 2 + 1 + 2 + 5 + 8 + 4 + 4 + 2 + 0 + 24 = 54
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 54 = 6									6

The NPI number 1265442206 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.