LAQUISHA S MARK MD
NPI 1679739163
Student in an Organized Health Care Education/Training Program in Dayton, OH

Active since August 04, 2008PECOS EnrolledAccepts Medicare Assignment
2345 PHILADELPHIA DR, DAYTON, OH 45406(937) 276-4141(937) 277-7249 Get Directions Write a Review

NPPES record last updated: December 2, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Laquisha S Mark Md NPPES

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

LAQUISHA S MARK MD (NPI 1679739163) is an individual student in an organized health care education/training program in Dayton, Ohio, licensed in Ohio (57-014699) and active in the NPI registry since August 2008. She is enrolled in Medicare PECOS and is a graduate of Other (2006).

NPPES Registry Identity

NPI1679739163
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameLAQUISHA S MARKCredential: MD
Location Address2345 PHILADELPHIA DRDayton, OH 45406-1816
Mailing Address529 Crawley Run, Apt. #208Centerville, OH 45458-6396
Fax(937) 277-7249
Sole ProprietorNo
Medical School CMSOtherGraduated 2006
Enumeration DateAugust 4, 2008
Last NPPES UpdateDecember 2, 2021
NPPES CertifiedDecember 2, 2021
✔ NPI 1679739163 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code390200000X
License✔ Licensed in OH · 57-014699
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
2345 PHILADELPHIA DR, Dayton, OH 45406

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

Laquisha S Mark 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 ID3577723600
PECOS Enrollment IDI20120328000361
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 Reassignment

Medicare enrollment records show Laquisha Mark reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Health Maintenance Organization
3527 W FLORIDA AVE
Hemet, CA 92545
  • Reassigned Medicare billing, California enrollment
  • Also billed through NPI 1225060742 (California)
  • 5,228 clinicians in this Medicare group

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

Other Providers at the Same Location NPPES 10

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

Emergency Medicine
2345 PHILADELPHIA DR
DAYTON, OH 45406
Registered Nurse
2345 PHILADELPHIA DR
DAYTON, OH 45406
Registered Nurse
2345 PHILADELPHIA DR
DAYTON, OH 45406
Dietitian, Registered
2345 PHILADELPHIA DR
DAYTON, OH 45406
Family Medicine
2345 PHILADELPHIA DR
DAYTON, OH 45406
Registered Nurse
2345 PHILADELPHIA DR
DAYTON, OH 45406
Nurse Practitioner
2345 PHILADELPHIA DR
DAYTON, OH 45406
Licensed Practical Nurse
2345 PHILADELPHIA DR
DAYTON, OH 45406

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 Laquisha Mark's NPI number?

The NPI number for Laquisha Mark is 1679739163. It was assigned to this individual provider in the NPPES registry on August 4, 2008.

Where is Laquisha Mark located?

Laquisha Mark practices at 2345 Philadelphia Dr, Dayton, OH 45406. The listed phone number is (937) 276-4141.

What is Laquisha Mark's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Laquisha Mark enrolled in Medicare?

Yes. Laquisha Mark 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 organization bills Medicare for Laquisha Mark's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Laquisha Mark reassigns Medicare benefits to Southern California Permanente Medical Group (Hemet, CA). The 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 Laquisha Mark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Laquisha Mark was last updated on December 2, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.