DR. MARK PETER ALEXANDER M.D., MBA
NPI 1316097223
Internal Medicine in Ventnor City, NJ

NPI Status: Active since January 11, 2007

Contact Information

5301 WELLINGTON AVE
VENTNOR CITY, NJ
ZIP 08406
Phone: (609) 823-0555
Fax: (609) 823-0330

NPI Profile Information
Primary Taxonomy
Secondary Taxonomies
Insurance Plans Accepted
Medicare Participation & PECOS Status
Areas of Expertise
Durable Medical Equipment
Physician Visit Costs
Quality Reporting
NPI Validation
Frequently Asked Questions

Individual
Male
Years of Experience 43
Internal Medicine
Accepts Insurance
Accepts Medicare Approved Payment
PECOS Enrolled
Medicare Quality Reporting

About MARK ALEXANDER

This page provides the complete NPI Profile along with additional information for Mark Alexander, an internist established in Ventnor City, New Jersey with a medical specialization in Internal Medicine and more than 43 years of experience. The healthcare provider is registered in the NPI registry with number 1316097223 assigned on January 2007. The practitioner's primary taxonomy code is 207R00000X with license number 25MA08323800 (NJ). The provider is registered as an individual and his NPI record was last updated 9 years ago.

NPI: 1316097223
Provider Name: DR. MARK PETER ALEXANDER M.D., MBA
Other Name: DR. EMAD CHAFFIC CHAROAPEAM M.D.
Other Name Type: Former Name (1)
Gender: Male
Entity Type: Individual
Location Address: 5301 WELLINGTON AVE VENTNOR CITY, NJ 08406
Location Phone: (609) 823-0555
Location Fax: (609) 823-0330
Mailing Address: 5301 WELLINGTON AVE VENTNOR CITY, NJ 08406
Mailing Phone: (609) 823-0555
Mailing Fax: (609) 823-0330
Medical School Name: OTHER
Graduation Year: 1983
Is Sole Proprietor?: Yes
Enumeration Date: 01-11-2007
Last Update Date: 05-10-2017
Code Navigator

An internist like Mark Alexander 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

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
Taxonomy Code: 207R00000X
Type: Allopathic & Osteopathic Physicians
License No.: 25MA08323800
License State: NJ
Taxonomy Description: A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

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)
1	207R00000X	Allopathic & Osteopathic Physicians	Internal Medicine	112522 (MO)
2	207R00000X	Allopathic & Osteopathic Physicians	Internal Medicine	04-26767 (KS)

Insurance Plans Accepted

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

Ambetter Health

Complete Gold - HMO
Complete Gold + Vision + Adult Dental - HMO
Elite Bronze - HMO
Elite Bronze + Vision + Adult Dental - HMO
Everyday Bronze - HMO
Everyday Bronze + Vision + Adult Dental - HMO
Everyday Gold - HMO
Everyday Gold + Vision + Adult Dental - HMO
Focused Silver - HMO
Focused Silver + Vision + Adult Dental - HMO
Standard Expanded Bronze - HMO
Standard Expanded Bronze + Vision + Adult Dental - HMO
Standard Gold - HMO
Standard Gold + Vision + Adult Dental - HMO
Standard Silver - HMO
Standard Silver + Vision + Adult Dental - HMO

Ambetter Health of Delaware

Clear Gold - EPO
Clear Gold + Vision + Adult Dental - EPO
Complete Gold - EPO
Complete Gold + Vision + Adult Dental - EPO
Elite Silver - EPO
Elite Silver + Vision + Adult Dental - EPO
Everyday Bronze - EPO
Everyday Bronze + Vision + Adult Dental - EPO
Focused Silver - EPO
Focused Silver + Vision + Adult Dental - EPO
Principal Bronze HSA - EPO
Principal Bronze HSA + 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

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

Medicare Participation & PECOS Enrollment Status

Mark Alexander 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 Alexander 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: 6901960863
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: I20090122000091
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

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

DME-Other DME (DE017N)
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)
7 DME suppliers used 24 Medicare Claims 93 Services Paid
DME-Wheelchairs (DD000N)
Standard wheelchair (HCPCS:K0001)
3 DME suppliers used 16 Medicare Claims 23 Services Paid
DME-Other DME (DE017N)
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service (HCPCS:K0553)
2 DME suppliers used 48 Medicare Claims 48 Services Paid

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 influenza virus vaccine
Advance care planning, first 30 minutes
Annual alcohol misuse screening, 15 minutes
Annual depression screening, 15 minutes
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit
Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes
Aspiration and/or injection of fluid from large joint
Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month
Chronic care management services for two or more chronic conditions, first 30 minutes provided personally by health care professional, per calendar month
Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month
Complex chronic care management services for two or more chronic conditions, each additional 60 minutes of clinical staff time directed by health care professional, per calendar month
Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time directed by health care professional, per calendar month
Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)
Electrocardiogram (ecg) 1 to 3 leads with review by physician
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
Evaluation of use of breathing device
Face-to-face behavioral counseling for obesity, 15 minutes
High intensity behavioral counseling to prevent sexually transmitted infection; face-to-face, individual, includes: education, skills training and guidance on how to change sexual behavior; performed semi-annually, 30 minutes
Influenza vaccine, quadrivalent, 0.5 ml dosage
Inhalation treatment for airway obstruction or sputum production
Injection of drug or substance under skin or into muscle
Injection, methylprednisolone acetate, 40 mg
Injection, triamcinolone acetonide, not otherwise specified, 10 mg
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg
Melanoma (skin cancer) excision
New patient office or other outpatient visit, 45-59 minutes
New patient office or other outpatient visit, 60-74 minutes
Removal of impacted ear wax
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report
Smoking and tobacco use intensive counseling, more than 10 minutes
Transitional care management services for problem of high complexity

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $35.08 for a new patient copayment and $26.98 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 08406 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

Average New Patient Price $140.34
Minimum New Patient Price $61.59
Maximum New Patient Price $185.05

Average New Patient Copayment $35.08
Minimum New Patient Copayment $15.39
Maximum New Patient Copayment $46.26

Established Patients Visit Costs *

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

Average Established Patient Price $107.94
Minimum Established Patient Price $20.08
Maximum Established Patient Price $150.98

Average Established Patient Copayment $26.98
Minimum Established Patient Copayment $5.02
Maximum Established Patient Copayment $37.74

* 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
Advance Care Planning	Yes	N/A
Implementation of practices/processes to develop advance care planning that includes: documenting the advance care plan or living will within the medical record, educating clinicians about advance care planning motivating them to address advance care planning needs of their patients, and how these needs can translate into quality improvement, educating clinicians on approaches and barriers to talking to patients about end-of-life and palliative care needs and ways to manage its documentation, as well as informing clinicians of the healthcare policy side of advance care planning.
Annual registration in the Prescription Drug Monitoring Program	Yes	N/A
Annual registration by eligible clinician or group in the prescription drug monitoring program of the state where they practice. Activities that simply involve registration are not sufficient. MIPS eligible clinicians and groups must participate for a minimum of 6 months.
Care transition documentation practice improvements	Yes	N/A
Implementation of practices/processes for care transition that include documentation of how a MIPS eligible clinician or group carried out a patient-centered action plan for first 30 days following a discharge (e.g., staff involved, phone calls conducted in support of transition, accompaniments, navigation actions, home visits, patient information access, etc.).
Chronic Care and Preventative Care Management for Empaneled Patients	Yes	N/A
Proactively manage chronic and preventive care for empaneled patients that could include one or more of the following: • Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions; • Use condition-specific pathways for care of chronic conditions (e.g., hypertension, diabetes, depression, asthma and heart failure) with evidence-based protocols to guide treatment to target; such as a CDC-recognized diabetes prevention program; • Use pre-visit planning to optimize preventive care and team management of patients with chronic conditions; • Use panel support tools (registry functionality) to identify services due; • Use predictive analytical models to predict risk, onset and progression of chronic diseases; or • Use reminders and outreach (e.g., phone calls, emails, postcards, patient portals and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation.
Depression screening	Yes	N/A
Depression screening and follow-up plan: Regular engagement of MIPS eligible clinicians or groups in integrated prevention and treatment interventions, including depression screening and follow-up plan (refer to NQF #0418) for patients with co-occurring conditions of behavioral or mental health conditions.
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	91%	2852
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Immunization Registry Reporting	Yes	N/A
The MIPS eligible clinician is in active engagement with a public health agency to submit immunization data.
Implementation of medication management practice improvements	Yes	N/A
Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews.
Medication Reconciliation	100%	3758
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	100%	1049
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 Patient Access	14%	1049
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	3%	1049
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.
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.
Use of decision support and standardized treatment protocols	Yes	N/A
Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs.
Use of QCDR to support clinical decision making	Yes	N/A
Participation in a QCDR, demonstrating performance of activities that promote implementation of shared clinical decision making capabilities.

NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1316097223, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 57. The final step is to find the difference between that total and the next multiple of ten (60 - 57 = 3).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 2

Pos 4

Unchanged

Pos 5

Doubled → 0

Pos 6

Unchanged

Pos 7

Doubled → 14 → 1 + 4

Pos 8

Unchanged

Pos 9

Doubled → 4

Check

Target digit

Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 1 → 2 0 → 0 7 → 14 → 5 2 → 4

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 3 + 2 + 6 + 0 + 9 + 1 + 4 + 2 + 4 + 24 = 57

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 57 is 60. The difference is the calculated check digit.

60 - 57 = 3

This NPI is valid

The calculated check digit is 3, which matches the last digit of 1316097223.

About MARK ALEXANDER

Location Map

Specialty - Primary Taxonomy

Internal Medicine

Secondary Taxonomies

Internal Medicine

Internal Medicine

Insurance Plans Accepted

Ambetter Health

Ambetter Health of Delaware

Medicare Participation & PECOS Enrollment Status

Is the provider registered in PECOS? Yes

PECOS PAC ID: 6901960863

PECOS Enrollment ID: I20090122000091

Accepts Medicare Assignment? 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

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

Durable Medical Equipment

Areas of Expertise

Administration of influenza virus vaccine

Advance care planning, first 30 minutes

Annual alcohol misuse screening, 15 minutes

Annual depression screening, 15 minutes

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit

Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit

Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes

Aspiration and/or injection of fluid from large joint

Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month

Chronic care management services for two or more chronic conditions, first 30 minutes provided personally by health care professional, per calendar month

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month

Complex chronic care management services for two or more chronic conditions, each additional 60 minutes of clinical staff time directed by health care professional, per calendar month

Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time directed by health care professional, per calendar month

Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)

Electrocardiogram (ecg) 1 to 3 leads with review by physician

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

Evaluation of use of breathing device

Face-to-face behavioral counseling for obesity, 15 minutes

High intensity behavioral counseling to prevent sexually transmitted infection; face-to-face, individual, includes: education, skills training and guidance on how to change sexual behavior; performed semi-annually, 30 minutes

Influenza vaccine, quadrivalent, 0.5 ml dosage

Inhalation treatment for airway obstruction or sputum production

Injection of drug or substance under skin or into muscle

Injection, methylprednisolone acetate, 40 mg

Injection, triamcinolone acetonide, not otherwise specified, 10 mg

Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg

Melanoma (skin cancer) excision

New patient office or other outpatient visit, 45-59 minutes

New patient office or other outpatient visit, 60-74 minutes

Removal of impacted ear wax

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report

Smoking and tobacco use intensive counseling, more than 10 minutes

Transitional care management services for problem of high complexity

Physician Visit Costs

New Patients Visit Costs *

Established Patients Visit Costs *

Quality Reporting

Reviews for DR. MARK PETER ALEXANDER M.D., MBA

NPI NPI Number Validation

How NPI Validation Works

Digit-by-digit view

Step 1: Double every other digit from the right

Step 2: Add all digits plus the NPI constant

Step 3: Find the amount needed to reach the next multiple of 10

Frequently Asked Questions

What is Mark Alexander's NPI number?

Where is the provider located?

What is the provider's specialty?

What insurance does Mark Alexander accept?