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MARK T FAHLEN MD
NPI 1679539415
Internal Medicine - Nephrology in Modesto, CA

Active since April 21, 2006PECOS EnrolledAccepts Medicare Assignment
91.45/100
CMS Quality Rating
1400 FLORIDA AVE, SUITE 109, MODESTO, CA 95350(209) 544-2910 Get Directions Write a Review

NPPES record last updated: August 2, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mark T Fahlen Md NPPES

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

MARK T FAHLEN MD (NPI 1679539415) is an individual nephrology provider in Modesto, California, licensed in California (A81212) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS and is a graduate of Albany Medical College Of Union University (1998).

NPPES Registry Identity

NPI1679539415
Entity TypeIndividualMale
Primary Taxonomy207RN0300X
Provider Legal NameMARK T FAHLENCredential: MD
Location Address1400 FLORIDA AVE, SUITE 109Modesto, CA 95350-4422
Mailing Address1400 Florida Ave, Suite 109Modesto, CA 95350-4422 · (209) 544-2910
Phone(209) 544-2910
Sole ProprietorYes
Medical School CMSAlbany Medical College Of Union UniversityGraduated 1998
Enumeration DateApril 21, 2006
Last NPPES UpdateAugust 2, 2011
✔ NPI 1679539415 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
License✔ Licensed in CA · A81212
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
Also ListedInternal MedicineTaxonomy 207R00000X · License A81212 (CA)
1400 FLORIDA AVE, Modesto, CA 95350
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Other Identifiers 1

Medicare UPINH85858CA

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 T Fahlen 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 ID1850367111
PECOS Enrollment IDI20040908000652
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 8

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.

Dialysis services, 1 physician visit per month (20 years or older) 90962
Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can’t do their job. A physician visit once a month ensures your treatment is working effectively and adjusts it if necessary. This service is available for individuals aged 20 years and older.
772 services106 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.
487 services219 patients
Hemodialysis procedure with physician evaluation 90935
Hemodialysis is a treatment that uses a machine to filter waste and excess fluid from your blood when your kidneys can't. A physician checks your health before, during, and after the procedure to ensure it's working effectively for you.
362 services78 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.
334 services98 patients
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.
76 services60 patients
Dialysis services, 2-3 physician visits per month (20 years or older) 90961
Dialysis is a treatment that performs the function of healthy kidneys if they're not working properly. It removes waste and excess fluid from your blood. 2-3 physician visits per month are recommended for monitoring your health and adjusting your treatment as needed. This service is available for those aged 20 years and older.
72 services40 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95350 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
$133.94 typical visit price
range $58.87 – $176.60
Typical copayment $33.48 (range $14.71 – $44.15)
Most-billed visit code 99204
Established Patient
$103.36 typical visit price
range $19.28 – $144.60
Typical copayment $25.84 (range $4.82 – $36.15)
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.

91.45/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality67.86
Promoting Interoperability83
Improvement Activities40
Cost84.48

Reported Quality Measures

Advance Care Plan
19%404 patients1/55-star benchmark: 100%
Closing the Referral Loop: Receipt of Specialist Report
18%34 patients1/55-star benchmark: 87%
Colorectal Cancer Screening
16%214 patients1/55-star benchmark: 88%
Controlling High Blood Pressure
61%110 patients3/55-star benchmark: 91%
Diabetes: Eye Exam
0%129 patients1/55-star benchmark: 100%
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
45%129 patients3/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
89%925 patients4/55-star benchmark: 100%
e-Prescribing
99%611 patients4/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
19%360 patients1/55-star benchmark: 98%
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
23%325 patients2/55-star benchmark: 61%
Provide Patients Electronic Access to Their Health Information
11%282 patients1/55-star benchmark: 100%
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
92%177 patients5/55-star benchmark: 91%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 1% · 213 patients
Patients totalRate: 3% · 219 patients
2%219 patients4/55-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 8

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
4 suppliers19 claims45 services$6.60 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
2 suppliers13 claims13 services$1.13 avg. paid by Medicare
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each A4351
DME-Orthotic Devices · category DF008N
1 supplier13 claims1,700 services$1.47 avg. paid by Medicare
Tacrolimus, immediate release, oral, 1 mg J7507
Treatment-Treatment - Miscellaneous · category RX029N
2 suppliers11 claims3,734 services$0.32 avg. paid by Medicare
Mycophenolate mofetil, oral, 250 mg J7517
Treatment-Treatment - Miscellaneous · category RX029N
4 suppliers30 claims3,656 services$0.17 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
1 supplier12 claims12 services$169.80 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 19

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

BLANCA E. ZANK R.N. C.N.M.
Advanced Practice Midwife
1400 FLORIDA AVE, STE. 207
MODESTO, CA 95350
Stanislaus County (209) 522-1027
IRENE BELLE FEAVER R.N. C.N.M.
Advanced Practice Midwife
1400 FLORIDA AVE, STE. 207
MODESTO, CA 95350
Stanislaus County (209) 522-1027
SHAUNTON STUBBS DO
Orthopaedic Surgery
1400 FLORIDA AVE
MODESTO, CA 95350
Stanislaus County (209) 573-6183
JASMEET SINGH SAROYA
Student in an Organized Health Care Education/Training Program
1400 FLORIDA AVE
MODESTO, CA 95350
Stanislaus County (530) 713-6628
DR. JOHN MATTHEW EMERY III M.D.
Specialist
1400 FLORIDA AVE, SUITE 110
MODESTO, CA 95350
Stanislaus County (209) 524-6294
DR. SALMAN LADHA MD
Family Medicine
1400 FLORIDA AVE
MODESTO, CA 95350
Stanislaus County (909) 532-3574
DR. DANILO MARTINEZ MD
Neurological Surgery
1400 FLORIDA AVE, STE 104
MODESTO, CA 95350
Stanislaus County (209) 527-1651
FRED ADAMS M.D. INC
Preferred Provider Organization
1400 FLORIDA AVE, SUITE 205 A
MODESTO, CA 95350
Stanislaus County (209) 575-5844

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 Fahlen's NPI number?

The NPI number for Mark Fahlen is 1679539415. It was assigned to this individual provider in the NPPES registry on April 21, 2006.

Where is Mark Fahlen located?

Mark Fahlen practices at 1400 Florida Ave Suite 109, Modesto, CA 95350. The listed phone number is (209) 544-2910.

What is Mark Fahlen's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Mark Fahlen enrolled in Medicare?

Yes. Mark Fahlen 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.

When was this NPI record last updated?

The NPPES record for Mark Fahlen was last updated on August 2, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.