DR. MARK SOFIA DC
NPI 1619057627
Chiropractor in Lawrence, MA
NPI Status: Active since October 16, 2006
Contact Information
25 MARSTON ST
SUITE 205
LAWRENCE, MA
ZIP 01841
Phone: (978) 687-7117
Fax: (978) 687-7417
- Individual
- Male
- Years of Experience 32
- Chiropractor
- Accepts Insurance
- Accepts Medicare Approved Payment
About MARK SOFIA
This page provides the complete NPI Profile along with additional information for Mark Sofia, a provider established in Lawrence, Massachusetts with a medical specialization in Chiropractor and more than 32 years of experience. He graduated from New York Chiropractic College in 1995. The healthcare provider is registered in the NPI registry with number 1619057627 assigned on October 2006. The practitioner's primary taxonomy code is 111N00000X with license number CHI1930 (MA). The provider is registered as an individual and his NPI record was last updated one year ago.
- NPI
- 1619057627
- Provider Name
- DR. MARK SOFIA DC
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 25 MARSTON ST SUITE 205 LAWRENCE, MA 01841
- Location Phone
- (978) 687-7117
- Location Fax
- (978) 687-7417
- Mailing Address
- 25 MARSTON ST SUITE 205 LAWRENCE, MA 01841
- Mailing Phone
- (978) 687-7117
- Mailing Fax
- (978) 687-7417
- Medical School Name
- NEW YORK CHIROPRACTIC COLLEGE
- Graduation Year
- 1995
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 10-16-2006
- Last Update Date
- 05-20-2025
- Code Navigator
A chiropractor like Mark Sofia helps patients with problems of the neuromusculoskeletal system, which includes nerves, bones, muscles, ligaments, and tendons. Chiropractors use spinal adjustments and manipulation, as well as other clinical interventions, to manage health issues such as back and neck pain. Some chiropractors apply procedures like massage therapy, rehabilitative exercise, ultrasound and spinal adjustments and manipulation. A chiropractor focuses on the patients overall health and might refer patients to other healthcare professionals if necessary.
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
Chiropractor
- Taxonomy Code
- 111N00000X
- Type
- Chiropractic Providers
- License No.
- CHI1930
- License State
- MA
- Taxonomy Description
- A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Preferred Blue PPO 6000/20%/8000 w/HSA - PPO
- Anthem Bronze Preferred Blue PPO 7000/50%/8000 w/HSA - PPO
- Anthem Bronze Preferred Blue PPO 7500/30%/10000 Value - 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%/7500 RxD - PPO
- Anthem Gold Preferred Blue PPO 500/30%/9000 - PPO
- Anthem Platinum Preferred Blue PPO 250/10%/3500 - PPO
- Anthem Silver Preferred Blue PPO 2500/30%/10000 Value - PPO
- Anthem Silver Preferred Blue PPO 3000/30%/9000 Value - PPO
- Anthem Silver Preferred Blue PPO 3500/20%/10000 - PPO
- Anthem Silver Preferred Blue PPO 3500/20%/7250 w/HSA - PPO
- Anthem Silver Preferred Blue PPO 4000/0%/9000 - PPO
- Anthem Silver Preferred Blue PPO 4000/0%/9000 RxD - PPO
- Anthem Silver Preferred Blue PPO 4000/10%/7250 w/HSA - PPO
- Anthem Silver Preferred Blue PPO 4000/20%/8500 - PPO
- Anthem Bronze Pathway X Enhanced 6000/35% HSA - HMO
- Anthem Bronze Pathway X Enhanced 7000/0% ($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 - HMO
- Anthem Gold Pathway X Enhanced 1200/20% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Gold Pathway X Enhanced 2000/25% ($0 Virtual PCP + $0 Select Drug) Standard - HMO
- Anthem Gold Pathway X Enhanced 700/40% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Heart Healthy Bronze Pathway X Enhanced 6000/40% ($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 5500/20% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Silver Pathway X Enhanced 6000/40% ($0 Virtual PCP + $0 Select Drugs) Standard - HMO
- Anthem Bronze Access Blue New England HMO 6000/20%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 7000/50%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 7500/30%/10000 Value - HMO
- Anthem Bronze Access Blue New England HMO 8500/50%/9200 - HMO
- Anthem Bronze Pathway X HMO 6000/20%/8000 w/HSA - HMO
- Anthem Bronze Pathway X HMO 7000/50%/8000 w/HSA - HMO
- Anthem Bronze Pathway X HMO 7500/30%/10000 Value - HMO
- Anthem Bronze Pathway X HMO 8500/50%/9200 - HMO
- Connect 1500 Gold - EPO
- Connect 6000 Silver - EPO
- Connect 9800 Bronze - EPO
- HSA Qualified 7500 Bronze - Choice Network - EPO
- HSA-E Qualified 7500 Bronze - Signature Network - EPO
- Providence Oregon Standard Bronze Plan - Choice Network - EPO
- Providence Oregon Standard Bronze Plan - Signature Network - EPO
- Providence Oregon Standard Gold Plan - Choice Network - EPO
- Providence Oregon Standard Gold Plan - Signature Network - EPO
- Providence Oregon Standard Silver Plan - Choice Network - EPO
- Providence Oregon Standard Silver Plan - Signature Network - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Mark Sofia 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.
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.
PECOS PAC ID: 3779593488
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: I20060426000124
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.
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.
Chiropractic manipulative treatment, 3-4 spinal regions
Chiropractic manipulative treatment for 3-4 spinal regions involves a trained professional applying controlled force to specific areas of your spine. This can help alleviate pain, improve physical function, and support your body's natural healing process.
This service was performed 157 times for 20 patientsFind Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Mark Sofia is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| LAWRENCE GENERAL HOSPITAL | ONE GENERAL STREET LAWRENCE, MA 01842 | (978) 683-4000 | Acute Care Hospitals |
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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 1619057627, we treat the final digit (7) 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 63. The final step is to find the difference between that total and the next multiple of ten (70 - 63 = 7).
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 63 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.
LAWRENCE, MA 01841
LAWRENCE, MA 01841
LAWRENCE, MA 01841
LAWRENCE, MA 01841
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1619057627, enumerated as an "individual" on October 16, 2006.
The provider is located at 25 MARSTON ST SUITE 205 LAWRENCE, MA 01841 and the phone number is (978) 687-7117.
Chiropractor with taxonomy code 111N00000X.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Sheld, Anthem Blue. Please consult your insurance carrier or call the provider to verify.
Mark Sofia is affiliated with: LAWRENCE GENERAL HOSPITAL.
