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DR. MARK A SCHWARTZ M.D.
NPI 1639195449
Orthopaedic Surgery - Sports Medicine in Pottstown, PA

Active since July 14, 2006PECOS EnrolledAccepts Medicare Assignment
60.96/100
CMS Quality Rating
1601 MEDICAL DR, POTTSTOWN, PA 19464(610) 705-3055(610) 705-5790 Get Directions Write a Review

NPPES record last updated: October 23, 2013. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Mark A Schwartz M.d. NPPES

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

DR. MARK A SCHWARTZ M.D. (NPI 1639195449) is an individual sports medicine provider in Pottstown, Pennsylvania, licensed in Pennsylvania (MD435558) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS and is a graduate of Chicago College Of Medicine And Surgery (1999).

NPPES Registry Identity

NPI1639195449
Entity TypeIndividualMale
Primary Taxonomy207XX0005X
Provider Legal NameDR. MARK A SCHWARTZCredential: M.D.
Location Address1601 MEDICAL DRPottstown, PA 19464-3241
Mailing Address1591 Medical DrPottstown, PA 19464-3224 · (610) 326-8005 · Fax (610) 327-9629
Phone(610) 705-3055
Fax(610) 705-5790
Sole ProprietorNo
Medical School CMSChicago College Of Medicine And SurgeryGraduated 1999
Enumeration DateJuly 14, 2006
Last NPPES UpdateOctober 23, 2013
✔ NPI 1639195449 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic Surgery · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207XX0005X
License✔ Licensed in PA · MD435558
Definition
An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries.
1601 MEDICAL DR, Pottstown, PA 19464
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Other Identifiers 2

Medicare PIN113860D8PPA
Medicare UPINU62409

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Highmark Blue Cross Blue Shield Delaware, Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Mark A Schwartz M.d. 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 ID6305937277
PECOS Enrollment IDI20081229000375
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Mark Schwartz reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Premier Orthopaedic And Sports Medicine Associates, Ltd
21 mi
Orthopaedic Surgery
3809 W CHESTER PIKE, SUITE 150
Newtown Square, PA 19073
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 241 clinicians in this Medicare group
NPI 1215987243 (610) 359-5664
Philadelphia Smart Pain & Wellness, P.C.
26 mi
Pain Medicine
1 BALA AVE STE LL3
Bala Cynwyd, PA 19004
  • Reassigned Medicare billing, Pennsylvania enrollment
  • Medicare enrollment name: Philadelphia Smart Pain & Wellness PC
  • 4 clinicians in this Medicare group
NPI 1093257776 (215) 366-2803

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 11

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.
219 services140 patients
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg J0702
This injection contains two medications, betamethasone acetate and betamethasone sodium phosphate. It is used to reduce inflammation and pain. It's given by a healthcare professional, often directly into the area causing discomfort.
137 services58 patients
Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
91 services70 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
54 services54 patients
X-ray of shoulder, minimum of 2 views 73030
An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.
50 services36 patients
X-ray of knee, 4 or more views 73564
An X-ray of the knee, 4 or more views, is a non-invasive imaging test. It involves capturing multiple images of your knee from different angles. This helps in diagnosing conditions such as fractures, arthritis, or infections. The procedure is quick and painless.
48 services39 patients

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.

60.96/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality54.07
Improvement Activities40

Reported Quality Measures

Colorectal Cancer Screening
0%720 patients1/55-star benchmark: 88%
Controlling High Blood Pressure
5%20 patients1/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
93%2,168 patients4/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
22%333 patients1/55-star benchmark: 100%
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
0%1,801 patients1/55-star benchmark: 61%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients combinedPopulations: 69% · 939 patients
Patients screened: 73% · 939 patients
31%55 patients2/55-star benchmark: 100%
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
72%165 patients3/55-star benchmark: 91%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 0% · 348 patients
Patients totalRate: 0% · 348 patients
0%348 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims

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

Neuromuscular stimulator, electronic shock unit E0745
DME-Other DME · category DE000N
1 supplier19 claims19 services$71.20 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 5

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

JOHN A MALARA PA-C
Physician Assistant (Medical)
1601 MEDICAL DR
POTTSTOWN, PA 19464
Montgomery County (610) 705-3055
CAROLYN SMITH PT
Physical Therapist
1601 MEDICAL DR
POTTSTOWN, PA 19464
Montgomery County (610) 970-1600
MISS ANN M FREY PT
Physical Therapist
1601 MEDICAL DR
POTTSTOWN, PA 19464
Montgomery County (610) 327-7610
POTTSTOWN MEDICAL SPECIALISTS, INC
Health Educator
1601 MEDICAL DR
POTTSTOWN, PA 19464
Montgomery County (610) 327-4200
KENDRA HOLLY SALEM PA-C
Physician Assistant
1601 MEDICAL DR
POTTSTOWN, PA 19464
Montgomery County (610) 705-3055

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 Mark Schwartz's NPI number?

The NPI number for Mark Schwartz is 1639195449. It was assigned to this individual provider in the NPPES registry on July 14, 2006.

Where is Mark Schwartz located?

Mark Schwartz practices at 1601 Medical Dr, Pottstown, PA 19464. The listed phone number is (610) 705-3055.

What is Mark Schwartz's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Sports Medicine, with taxonomy code 207XX0005X.

Is Mark Schwartz enrolled in Medicare?

Yes. Mark Schwartz 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.

Which organizations bill Medicare for Mark Schwartz's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mark Schwartz reassigns Medicare benefits to 2 organizations: Premier Orthopaedic And Sports Medicine Associates, Ltd (Newtown Square, PA) and Philadelphia Smart Pain & Wellness, P.C. (Bala Cynwyd, PA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mark Schwartz's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Mark Schwartz accept?

Health plans from Highmark Blue Cross Blue Shield Delaware and Oscar Health list Mark Schwartz 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 Mark Schwartz was last updated on October 23, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.