DR. MARK DAVID PINKERTON MD
NPI 1437138328
Family Medicine in Cedarville, OH
NPI Status: Active since January 10, 2006
Contact Information
251 N MAIN ST
CEDARVILLE, OH
ZIP 45314
Phone: (937) 766-7417
Fax: (937) 766-7865
- Individual
- Male
- Family Medicine
- Accepts Insurance
- PECOS Enrolled
About MARK PINKERTON
This page provides the complete NPI Profile along with additional information for Mark Pinkerton, a primary care provider established in Cedarville, Ohio with a medical specialization in Family Medicine. The healthcare provider is registered in the NPI registry with number 1437138328 assigned on January 2006. The practitioner's primary taxonomy code is 207Q00000X with license number 35063921 (OH). The provider is registered as an individual and his NPI record was last updated 10 years ago.
- NPI
- 1437138328
- Provider Name
- DR. MARK DAVID PINKERTON MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 251 N MAIN ST CEDARVILLE, OH 45314
- Location Phone
- (937) 766-7417
- Location Fax
- (937) 766-7865
- Mailing Address
- 251 N MAIN ST CEDARVILLE, OH 45314
- Mailing Phone
- (937) 766-7417
- Mailing Fax
- (937) 766-7865
- Is Sole Proprietor?
- No
- Enumeration Date
- 01-10-2006
- Last Update Date
- 12-05-2016
- Code Navigator
A primary care provider (PCP) like Mark Pinkerton sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, 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
Family Medicine
- Taxonomy Code
- 207Q00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 35063921
- License State
- OH
- Taxonomy Description
- Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
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 | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | 33488 (CO) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Bronze 7500 $25 Generic Drugs - HMO
- Bronze 7500 $25 Generic Drugs + Adult Vision & Fitness - HMO
- Core Gold 1500 $10 Generic Drugs - HMO
- Core Gold 1500 $10 Generic Drugs + Adult Vision & Fitness - HMO
- Diabetes Gold 3000 $0 Chronic Care Drugs & Services - HMO
- Diabetes Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
- Diabetes Silver 5000 $0 Chronic Care Drugs & Services - HMO
- Diabetes Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
- Gold 2000 $15 Generic Drugs - HMO
- Gold 2000 $15 Generic Drugs + Adult Vision & Fitness - HMO
- Bronze Classic 4700 - HMO
- Bronze Classic 4700 | with AdventHealth - HMO
- Bronze Classic Standard - HMO
- Bronze Classic Standard | with AdventHealth - HMO
- Bronze Elite + PCP Saver Plus - HMO
- Bronze Elite + PCP Saver Plus | with AdventHealth - HMO
- Bronze Simple Breathe Easy with Enhanced COPD Benefits - HMO
- Bronze Simple Chronic Care CKM - HMO
- Bronze Simple Diabetes - HMO
- Gold Classic Standard - HMO
- Bronze Classic 4700 - HMO
- Bronze Classic 4700 | with Atrium Health - HMO
- Bronze Classic Standard - HMO
- Bronze Classic Standard | with Atrium Health - HMO
- Bronze Elite + PCP Saver Plus - HMO
- Bronze Elite + PCP Saver Plus | with Atrium Health - HMO
- Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health - HMO
- Bronze Simple Chronic Care CKM | with Atrium Health - HMO
- Bronze Simple Diabetes | with Atrium Health - HMO
- Gold Classic Standard - HMO
- Bronze Classic Standard - HMO
- Bronze Elite + PCP Saver Plus - HMO
- Bronze Simple - HMO
- Bronze Simple Breathe Easy with Enhanced COPD Benefits - HMO
- Bronze Simple Chronic Care CKM - HMO
- Buena Salud Bronce Simple Para Diabetes - HMO
- Gold Classic - HMO
- Gold Classic Standard - HMO
- Gold Simple - HMO
- Gold Simple Diabetes - HMO
- Bronze Classic - EPO
- Bronze Classic | with Bryan Health - EPO
- Bronze Classic 4700 - EPO
- Bronze Classic 4700 | MercyOne - EPO
- Bronze Classic Standard - EPO
- Bronze Classic Standard - PPO
- Bronze Classic Standard | MercyOne - EPO
- Bronze Classic Standard | with Bryan Health - EPO
- Bronze Elite + PCP Saver - EPO
- Bronze Elite + PCP Saver Plus - EPO
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 |
|---|---|---|---|
| F83947 | MEDICARE UPIN (02) | ||
| 01334887 | MEDICAID (05) | CO | |
| 3144912 | MEDICAID (05) | OH | |
| 4320081 | MEDICARE PIN (08) | OH |
Medicare Participation & PECOS Enrollment Status
Mark Pinkerton 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.
Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus
Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19)
Established patient office or other outpatient visit, 30-39 minutes
New patient office or other outpatient visit, 45-59 minutes
An immunoassay test for severe acute respiratory syndrome coronavirus is a diagnostic tool. It uses your body's immune response to detect the presence of the virus. It involves taking a sample, usually from your nose or throat, which is then analyzed in a lab for signs of the virus.
This service was performed 15 times for 15 patientsThis is a test to detect COVID-19, the virus causing severe respiratory illness. It uses a method called immunoassay, which identifies the virus by its unique proteins. The test is directly observed for accuracy. It helps determine if you're currently infected.
This service was performed 26 times for 24 patientsThis is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
This service was performed 51 times for 45 patientsThis 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.
This service was performed 46 times for 46 patientsPhysician 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 45314 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $84.72
- Minimum New Patient Price $54.34
- Maximum New Patient Price $166.65
- Average New Patient Copayment $21.18
- Minimum New Patient Copayment $13.58
- Maximum New Patient Copayment $41.66
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $96.44
- Minimum Established Patient Price $17.1
- Maximum Established Patient Price $135.4
- Average Established Patient Copayment $24.11
- Minimum Established Patient Copayment $4.27
- Maximum Established Patient Copayment $33.85
* 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 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 1437138328, we treat the final digit (8) 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 62. The final step is to find the difference between that total and the next multiple of ten (70 - 62 = 8).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 62 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
CEDARVILLE, OH 45314
CEDARVILLE, OH 45314
CEDARVILLE, OH 45314
CEDARVILLE, OH 45314
CEDARVILLE, OH 45314
CEDARVILLE, OH 45314
CEDARVILLE, OH 45314
CEDARVILLE, OH 45314
CEDARVILLE, OH 45314
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1437138328, enumerated as an "individual" on January 10, 2006.
The provider is located at 251 N MAIN ST CEDARVILLE, OH 45314 and the phone number is (937) 766-7417.
Family Medicine with taxonomy code 207Q00000X.
The provider might be accepting Accepts: CareSource, Oscar Health Maintenance Organization. Please consult your insurance carrier or call the provider to verify.
