MR. MARK R SUGHRUE MSN, APRN-BC
NPI 1285754614
Nurse Practitioner in Brentwood, NH

NPI Status: Active since March 30, 2007

Contact Information

21 PEABODY DR
BRENTWOOD, NH
ZIP 03833
Phone: (603) 347-5520

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  • Individual
  • Male
  • Years of Experience 24
  • Nurse Practitioner
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About MARK SUGHRUE

This page provides the complete NPI Profile along with additional information for Mark Sughrue, a provider established in Brentwood, New Hampshire with a medical specialization in Nurse Practitioner and more than 24 years of experience. The healthcare provider is registered in the NPI registry with number 1285754614 assigned on March 2007. The practitioner's primary taxonomy code is 363L00000X with license number 058300-23 (NH). The provider is registered as an individual and his NPI record was last updated 2 years ago.

NPI
1285754614
Provider Name
MR. MARK R SUGHRUE MSN, APRN-BC
Gender
Male
Entity Type
Individual
Location Address
21 PEABODY DR BRENTWOOD, NH 03833
Location Phone
(603) 347-5520
Mailing Address
21 PEABODY DR BRENTWOOD, NH 03833
Mailing Phone
(603) 347-5520
Medical School Name
OTHER
Graduation Year
2002
Is Sole Proprietor?
Yes
Enumeration Date
03-30-2007
Last Update Date
05-16-2023
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A nurse practitioner (NP) like Mark Sughrue is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.

Location Map

Secondary Locations

  • 706 Riverway Pl
    Bedford, NH 03110
    (603) 860-2516

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

Nurse Practitioner

Taxonomy Code
363L00000X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
058300-23
License State
NH
Taxonomy Description
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1363L00000XPhysician Assistants & Advanced Practice Nursing Providers

Nurse Practitioner

RN250422 (MA)
2363L00000XPhysician Assistants & Advanced Practice Nursing Providers

Nurse Practitioner

CNP231045 (ME)

Insurance Plans Accepted

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

  • Choice Bronze HSA - EPO
  • Choice Bronze HSA + Vision + Adult Dental - EPO
  • Clear Silver - EPO
  • Clear Silver + Vision + Adult Dental - EPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Complete Silver - EPO
  • Complete Silver + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Standard Silver + Vision + Adult Dental - EPO
  • 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 Gold Preferred Blue PPO 3000/0%/5500 RxD - PPO
  • Anthem Gold Preferred Blue PPO 500/25%/7000 - PPO
  • Anthem Platinum Preferred Blue PPO 250/10%/3500 - PPO
  • Anthem Silver Preferred Blue PPO 2000/30%/9000 Value - PPO
  • Anthem Silver Preferred Blue PPO 3000/20%/8500 - PPO
  • Anthem Silver Preferred Blue PPO 3000/30%/9000 Value - PPO
  • Anthem Silver Preferred Blue PPO 3500/20%/7250 w/HSA - PPO
  • Anthem Silver Preferred Blue PPO 4000/0%/8500 - PPO
  • Anthem Silver Preferred Blue PPO 4000/0%/8500 RxD - PPO
  • Anthem Silver Preferred Blue PPO 4000/10%/7250 w/HSA - PPO
  • 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
  • Anthem Silver Pathway X Enhanced 5000/40% ($0 Virtual PCP + $0 Select Drugs) Standard - HMO
  • Anthem Silver Pathway X Enhanced 5500/20% ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Bronze Access Blue New England HMO 5000/10%/8000 w/HSA - HMO
  • Anthem Bronze Access Blue New England HMO 5000/20%/8000 w/HSA - HMO
  • Anthem Bronze Access Blue New England HMO 6500/30%/9200 Value - HMO
  • Anthem Bronze Access Blue New England HMO 7000/50%/8000 w/HSA - HMO
  • Anthem Bronze Access Blue New England HMO 8500/50%/9200 - HMO
  • Anthem Bronze Pathway X HMO 5000/10%/8000 w/HSA - HMO
  • Anthem Bronze Pathway X HMO 5000/20%/8000 w/HSA - HMO
  • Anthem Bronze Pathway X HMO 6500/30%/9200 Value - HMO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

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

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
30346055MEDICAID (05)NH 

Medicare Participation & PECOS Enrollment Status

Mark Sughrue is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Mark Sughrue 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

  • PECOS PAC ID: 9436163060

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20071029000598

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • 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

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $22.28 for a new patient copayment and $25.38 for an established patient copayment.

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 03833 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $89.14
  • Minimum New Patient Price $57.75
  • Maximum New Patient Price $174.26
  • Average New Patient Copayment $22.28
  • Minimum New Patient Copayment $14.43
  • Maximum New Patient Copayment $43.56

Established Patients Visit Costs *

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

  • Average Established Patient Price $101.54
  • Minimum Established Patient Price $18.7
  • Maximum Established Patient Price $142.15
  • Average Established Patient Copayment $25.38
  • Minimum Established Patient Copayment $4.67
  • Maximum Established Patient Copayment $35.53

* 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.

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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.
1285754614
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
22165145862
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 2 + 1 + 6 + 5 + 1 + 4 + 5 + 8 + 6 + 2 + 24 = 66
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 66 = 44

The NPI number 1285754614 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1285754614, enumerated as an "individual" on March 30, 2007.

The provider is located at 21 PEABODY DR BRENTWOOD, NH 03833 and the phone number is (603) 347-5520.

Nurse Practitioner with taxonomy code 363L00000X.

The provider might be accepting Accepts: Ambetter from NH Healthy Families, Anthem Blue. Please consult your insurance carrier or call the provider to verify.