MARC A KAPLAN DO
NPI 1619918836
Family Medicine in Sierra Vista, AZ

Q: What is Marc Kaplan's NPI number?

The NPI number for Marc Kaplan is 1619918836. It was assigned to this individual provider in the NPPES registry on June 9, 2006.

Q: What is Marc Kaplan's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Marc Kaplan was last updated on September 27, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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 June 09, 2006PECOS EnrolledAccepts Medicare AssignmentCLIA 03D0895650 · Microscopy

72.15/100

CMS Quality Rating

2585 E WILCOX DR., #C, SIERRA VISTA, AZ 85635(520) 459-0000(520) 459-5141 Get Directions Write a Review

NPPES record last updated: September 27, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Marc A Kaplan Do NPPES

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

MARC A KAPLAN DO (NPI 1619918836) is an individual family medicine provider in Sierra Vista, Arizona, licensed in Arizona (1872) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, holds a CLIA Microscopy certificate valid through September 4, 2027, and is a graduate of At Still University Of Health Sciences, College Of Osteo Med, Kirksville (1981).

NPPES Registry Identity

NPI1619918836

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameMARC A KAPLANCredential: DO

Location Address2585 E WILCOX DR., #CSierra Vista, AZ 85635

Mailing Address2585 E Wilcox Dr., #cSierra Vista, AZ 85635 · (520) 459-0000 · Fax (520) 459-5141

Phone(520) 459-0000

Fax(520) 459-5141

Sole ProprietorYes

Medical School CMSAt Still University Of Health Sciences, College Of Osteo Med, KirksvilleGraduated 1981

Enumeration DateJune 9, 2006

Last NPPES UpdateSeptember 27, 2007

✔ NPI 1619918836 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in AZ · 1872

Definition

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.

2585 E WILCOX DR., Sierra Vista, AZ 85635

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Other Identifiers 6

Medicare UPINE39208AZ

Medicare PINZ103269AZ

Other4114163Aetna

Medicaid255465AZ

OtherAZ0779310Bcbs Az

Medicare ID-Type Unspecified103269

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Arizona.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

Marc A Kaplan Do 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 ID941108450

PECOS Enrollment IDI20050607000491

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.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 03D0895650

Marc A Kaplan PLLC · Sierra Vista, AZ

Active · expires Sep 4, 2027

CLIA Number03D0895650

Laboratory TypePhysician Office

Certificate Effective DateSeptember 5, 2025

Certificate Expiration DateSeptember 4, 2027

Laboratory DirectorMarc A. Kaplan Do

Laboratory Phone(520) 459-0000

Laboratory LocationMarc A Kaplan PLLC2585 East Wilcox Suite C, Sierra Vista, AZ 85635

CLIA data matches this NPI record on: Phone

This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Areas of Expertise CMS Part B claims 21

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.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

531 services303 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This 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.

492 services279 patients

Injection, dexamethasone sodium phosphate, 1 mg J1100

Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.

295 services25 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

166 services91 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

158 services158 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

139 services137 patients

Annual depression screening, 5 to 15 minutes G0444

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

138 services138 patients

Professional service for multiple injections of allergen 95117

The professional service for multiple injections of allergens involves administering small doses of specific allergens into your body. This is done to help your immune system become less sensitive to them, reducing your allergic reaction over time. It's a safe, effective way to manage allergies.

111 services13 patients

Blood test, clotting time 85610

A clotting time blood test helps determine how quickly your blood forms clots, a process crucial to stop bleeding. During the test, a small blood sample is taken from your arm. The sample is then analyzed in a lab to see how long it takes for a clot to form.

91 services13 patients

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

72 services17 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

62 services62 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

60 services60 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

58 services56 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

53 services28 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

43 services27 patients

Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza 87428

This test uses a method called immunoassay to identify severe acute respiratory syndrome coronavirus and influenza. It works by detecting specific proteins (antigens) in a sample, like a nasal swab. It's a powerful tool in diagnosing these viral infections.

36 services32 patients

Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional 99211

This service involves an outpatient visit for established patients who may not need direct interaction with a healthcare professional. It could include reviewing test results, monitoring existing conditions, or adjusting treatment plans. It's typically done remotely, ensuring your comfort and convenience.

34 services14 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

29 services27 patients

Removal of impacted ear wax 69210

Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.

19 services17 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This 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.

17 services17 patients

Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit G0438

An annual wellness visit is a yearly appointment with your doctor to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's an opportunity to discuss your health status and goals and get a plan tailored for you.

13 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85635 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

$85.89 typical visit price

range $55.44 – $168.60

Typical copayment $21.47 (range $13.86 – $42.15)

Most-billed visit code 99203

Established Patient

$98.00 typical visit price

range $17.72 – $137.41

Typical copayment $24.50 (range $4.43 – $34.35)

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.

72.15/100

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

Scored as part of a group practice

Quality

87.68

Promoting Interoperability

Improvement Activities

Cost

53.67

Referred Medical Equipment & Supplies CMS DME claims 19

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

7 suppliers34 claims73 services$6.54 avg. paid by Medicare

Tubing with integrated heating element for use with positive airway pressure device A4604

DME-Other DME · category DE001N

3 suppliers16 claims16 services$38.65 avg. paid by Medicare

Full face mask used with positive airway pressure device, each A7030

DME-Other DME · category DE001N

4 suppliers38 claims38 services$83.25 avg. paid by Medicare

Face mask interface, replacement for full face mask, each A7031

DME-Other DME · category DE001N

4 suppliers36 claims91 services$33.44 avg. paid by Medicare

Cushion for use on nasal mask interface, replacement only, each A7032

DME-Other DME · category DE001N

1 supplier12 claims78 services$20.19 avg. paid by Medicare

Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034

DME-Other DME · category DE001N

2 suppliers13 claims15 services$59.60 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

4 suppliers34 claims34 services$18.39 avg. paid by Medicare

Tubing used with positive airway pressure device A7037

DME-Other DME · category DE001N

3 suppliers37 claims39 services$15.53 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

4 suppliers51 claims281 services$2.34 avg. paid by Medicare

Water chamber for humidifier, used with positive airway pressure device, replacement, each A7046

DME-Other DME · category DE001N

3 suppliers25 claims25 services$12.19 avg. paid by Medicare

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

DME-Oxygen and Supplies · category DC000N

2 suppliers77 claims78 services$16.25 avg. paid by Medicare

Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466

DME-Other DME · category DE005N

1 supplier12 claims12 services$907.03 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

1 supplier12 claims12 services$5.28 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

3 suppliers41 claims41 services$31.35 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 suppliers163 claims164 services$85.60 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

4 suppliers76 claims79 services$33.20 avg. paid by Medicare

Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620

DME-Drugs Administered Through DME · category DG006N

4 suppliers19 claims1,680 services$0.09 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

3 suppliers11 claims11 services$184.44 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513

DME-Other DME · category DE000N

4 suppliers21 claims21 services$24.80 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Marc Kaplan's NPI number?

The NPI number for Marc Kaplan is 1619918836. It was assigned to this individual provider in the NPPES registry on June 9, 2006.

Where is Marc Kaplan located?

Marc Kaplan practices at 2585 E Wilcox Dr. #c, Sierra Vista, AZ 85635. The listed phone number is (520) 459-0000.

What is Marc Kaplan's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Marc Kaplan enrolled in Medicare?

Yes. Marc Kaplan is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Does Marc Kaplan hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 03D0895650) is associated with this NPI, valid through September 4, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Marc Kaplan accept?

Health plans from Blue Cross Blue Shield of Arizona list Marc Kaplan as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Marc Kaplan was last updated on September 27, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.

About Marc A Kaplan Do NPPES

NPPES Registry Identity

Specialties & Licenses

Other Identifiers 6

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare Enrollment Status

CLIA Laboratory Certificates CMS CLIA

Certificate for Provider-Performed Microscopy Procedures (PPMP) · 03D0895650

Areas of Expertise CMS Part B claims 21

Physician Visit Costs CMS claims · ZIP area

Medicare Quality Performance CMS QPP · MIPS

Referred Medical Equipment & Supplies CMS DME claims 19

Frequently Asked Questions NPPES & CMS

What is Marc Kaplan's NPI number?

Where is Marc Kaplan located?

What is Marc Kaplan's specialty?

Is Marc Kaplan enrolled in Medicare?

Does Marc Kaplan hold a CLIA laboratory certificate?

What insurance does Marc Kaplan accept?

When was this NPI record last updated?

Certificate for Provider-Performed Microscopy Procedures (PPMP) 03D0895650