MARK DUNCAN MD
NPI 1407275233
Hospitalist in Aurora, CO

Q: What is Mark Duncan's NPI number?

The NPI number for Mark Duncan is 1407275233. It was assigned to this individual provider in the NPPES registry on April 9, 2014.

Q: What is Mark Duncan's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Q: When was this NPI record last updated?

The NPPES record for Mark Duncan was last updated on August 16, 2018. 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.

Active since April 09, 2014PECOS EnrolledAccepts Medicare Assignment

97.58/100

CMS Quality Rating

12605 E 16TH AVE, AURORA, CO 80045(720) 848-0000 Get Directions Write a Review

NPPES record last updated: August 16, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Mark Duncan Md NPPES

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

MARK DUNCAN MD (NPI 1407275233) is an individual hospitalist provider in Aurora, Colorado, licensed in Colorado (DR.0060581) and active in the NPI registry since April 2014. He is enrolled in Medicare PECOS and is a graduate of University Of California, Geffen School Of Medicine (2014).

NPPES Registry Identity

NPI1407275233

Entity TypeIndividualMale

Primary Taxonomy208M00000X

Provider Legal NameMARK DUNCANCredential: MD

Location Address12605 E 16TH AVEAurora, CO 80045

Mailing AddressPo Box 110429Aurora, CO 80042-0429

Phone(720) 848-0000

Sole ProprietorNo

Medical School CMSUniversity Of California, Geffen School Of MedicineGraduated 2014

Enumeration DateApril 9, 2014

Last NPPES UpdateAugust 16, 2018

✔ NPI 1407275233 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians

Taxonomy Code208M00000X

License✔ Licensed in CO · DR.0060581

Definition

Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.

Also ListedInternal MedicineTaxonomy 207R00000X · License DR.0060581 (CO)

12605 E 16TH AVE, Aurora, CO 80045

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica, 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 Duncan Md 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 ID6901175355

PECOS Enrollment IDI20180831000779

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 5

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.

80 services46 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.

31 services30 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.

29 services29 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.

19 services15 patients

Aspiration of fluid from chest cavity using imaging guidance 32555

This procedure, known as a thoracentesis, involves removing fluid from the space between the lungs and chest wall, called the pleural space. It's performed under imaging guidance to ensure precision. It can help diagnose conditions or relieve symptoms like shortness of breath.

17 services15 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 80045 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

$132.55 typical visit price

range $58.06 – $174.82

Typical copayment $33.13 (range $14.51 – $43.70)

Most-billed visit code 99204

Established Patient

$102.03 typical visit price

range $18.88 – $142.79

Typical copayment $25.50 (range $4.72 – $35.69)

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.

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.

97.58/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

86.53

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 2

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

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

4 suppliers32 claims32 services$15.29 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

5 suppliers40 claims40 services$68.47 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 20

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

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