MARK A SUTTON MD
NPI 1699769935
Urology in Houston, TX

Q: What is Mark Sutton's NPI number?

The NPI number for Mark Sutton is 1699769935. It was assigned to this individual provider in the NPPES registry on September 1, 2005.

Q: What is Mark Sutton's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Q: When was this NPI record last updated?

The NPPES record for Mark Sutton was last updated on April 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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 September 01, 2005PECOS EnrolledAccepts Medicare Assignment

99.15/100

CMS Quality Rating

6560 FANNIN ST STE 1440, HOUSTON, TX 77030(713) 790-9700(713) 790-1328 Get Directions Write a Review

NPPES record last updated: April 27, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 27, 2026, Dec 8, 2020, Oct 15, 2019 (3 updates tracked since 2019).

On this page

About Mark A Sutton Md NPPES

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

MARK A SUTTON MD (NPI 1699769935) is an individual urology provider in Houston, Texas, licensed in Texas (K6353) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS, is affiliated with Houston Methodist Hospital, and is a graduate of University Of Washington School Of Medicine (1992).

NPPES Registry Identity

NPI1699769935

Entity TypeIndividualMale

Primary Taxonomy208800000X

Provider Legal NameMARK A SUTTONCredential: MD

Location Address6560 FANNIN ST STE 1440Houston, TX 77030-2713

Mailing Address6560 Fannin St Ste 1440Houston, TX 77030-2713 · (713) 351-0644 · Fax (713) 351-0633

Phone(713) 790-9700

Fax(713) 790-1328

Sole ProprietorNo

Medical School CMSUniversity Of Washington School Of MedicineGraduated 1992

Enumeration DateSeptember 1, 2005

Last NPPES UpdateApril 27, 20263 updates tracked since enumeration

NPPES CertifiedApril 27, 2026

✔ NPI 1699769935 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians

Taxonomy Code208800000X

License✔ Licensed in TX · K6353

Definition

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

6560 FANNIN ST STE 1440, Houston, TX 77030

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, UnitedHealthcare.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

Mark A Sutton 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 ID446257190

PECOS Enrollment IDI20061024000293

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 34

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.

Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml Q9967

Low osmolar contrast material with 300-399 mg/ml iodine concentration is a diagnostic tool used in imaging procedures. It helps to enhance the visibility of specific areas in the body, aiding in accurate diagnosis. It's safe and generally well-tolerated by patients.

1,400 services13 patients

Ultrasound measurement of bladder capacity after voiding 51798

Ultrasound measurement of bladder capacity after voiding is a non-invasive test that uses sound waves to create images of your bladder. It's done after you've emptied your bladder to see if there's any leftover urine, which can help diagnose certain conditions.

1,224 services917 patients

Leuprolide injectable, camcevi, 1 mg J1952

Camcevi, containing 1 mg of Leuprolide, is an injectable medication. It's used to manage certain health conditions by influencing hormone levels in your body. It's administered by a healthcare professional, usually once every month or as directed by your doctor.

840 services13 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

809 services659 patients

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

724 services591 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

721 services156 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.

621 services513 patients

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.

594 services513 patients

Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month 99439

Chronic Care Management services involve regular check-ins with healthcare professionals to manage two or more chronic conditions. It includes an additional 20 minutes of clinical staff time per month, directed by a healthcare professional, to ensure optimal health management.

285 services115 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.

99 services99 patients

Telephone medical discussion with physician, 21-30 minutes 99443

This service involves a 21-30 minute phone conversation with a physician. It's a chance for you to discuss your health concerns, symptoms or treatment plans. It's similar to an in-person consultation, but conducted over the phone for your convenience and safety.

92 services80 patients

Complete ultrasound scan behind abdominal cavity 76770

A complete ultrasound scan behind the abdominal cavity is a non-invasive imaging procedure. It uses sound waves to create pictures of the structures and organs located at the back of your abdomen. It helps in diagnosing health conditions and monitoring ongoing treatments.

53 services53 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.

50 services32 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.

43 services14 patients

Diagnostic exam of bladder and urethra using an endoscope 52000

This procedure involves using a thin, flexible tube with a light, called an endoscope, to examine the bladder and urethra. It helps in identifying any abnormalities or issues that may be causing discomfort or other symptoms.

39 services38 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

39 services33 patients

Diagnostic exam of bladder and urethra using an endoscope 52000

37 services35 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.

37 services37 patients

Ct scan of abdomen and pelvis without contrast 74176

A CT scan of the abdomen and pelvis is a non-invasive medical test. It uses special X-ray equipment to create detailed images of your abdominal and pelvic areas. This helps doctors examine organs, tissues, and vessels. No contrast dye is used in this procedure.

36 services35 patients

Ultrasound scan of pelvic region through rectum 76872

An ultrasound scan of the pelvic region through the rectum is a medical procedure where a small, smooth device is gently inserted into the rectum. This device uses sound waves to create images of the internal structures in the lower abdomen, aiding in diagnosis and treatment planning.

31 services31 patients

Ultrasonic guidance for needle placement 76942

Ultrasonic guidance for needle placement is a technique where sound waves create images that help accurately position the needle during procedures. This method ensures precision, minimizes discomfort, and increases safety.

31 services30 patients

Biopsy of prostate gland 55700

A biopsy of the prostate gland is a procedure where a small sample of tissue is taken from your body's internal gland, located near the bladder, for testing. This helps in diagnosing potential health issues. It's usually done with a fine needle and imaging technology for accuracy.

30 services30 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

27 services26 patients

Simple bladder irrigation and/or instillation 51700

Bladder irrigation and/or instillation is a process where a sterile solution is introduced into the bladder to cleanse it or deliver medication. This procedure helps manage certain bladder conditions, ensuring optimal bladder health.

23 services18 patients

Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle 96402

This procedure involves the injection of hormone-based anti-cancer drugs under the skin or into a muscle. These medications help to slow down or stop the growth of certain types of cancer cells. The process is usually quick and can be performed in a clinic or hospital.

21 services14 patients

Shock wave crushing of kidney stones 50590

Shock wave crushing of kidney stones, also known as Extracorporeal Shock Wave Lithotripsy (ESWL), is a non-invasive treatment. It involves the use of sound waves to break down kidney stones into small pieces that can easily pass through your urinary tract.

18 services15 patients

Electronic assessment of bladder emptying 51741

Electronic assessment of bladder emptying is a non-invasive test that measures how well your bladder functions. It uses ultrasound technology to create images of your bladder before and after you use the restroom, helping to identify any issues with bladder emptying.

18 services15 patients

Complete laser vaporization of prostate including control of bleeding using an endoscope 52648

This procedure involves using a special light instrument to carefully remove tissue from a gland located in the lower body. This helps improve the flow of body fluids. The process is done through a tube-like device and also controls any bleeding.

15 services15 patients

Simple insertion of temporary bladder tube 51702

This procedure involves placing a temporary tube into your bladder to help with urine flow. It's done when the body can't naturally remove urine. The tube is inserted through a small opening and allows urine to drain into a bag. It's usually a short-term solution.

14 services11 patients

Ct scan of abdomen and pelvis before and after contrast 74178

A CT scan of your abdomen and pelvis with and without contrast helps visualize your internal organs better. Contrast is a special dye that improves the clarity of the images. It's taken orally or injected into your veins before the scan. The process is painless and quick.

13 services13 patients

Crushing of stone of ureter with insertion of stent using an endoscope 52356

This procedure involves using a thin, flexible tube (endoscope) to locate and break down kidney stones in the ureter. After this, a small tube (stent) is inserted to help maintain an open pathway for urine to flow.

12 services12 patients

Injection procedure to cause erection 54235

This procedure involves administering a medication into your body to stimulate blood flow. It's designed to aid specific physical responses, similar to how adrenaline can increase heart rate. The medication is introduced via a small needle, and the effects typically occur shortly after.

12 services12 patients

Ultrasound scan of scrotum 76870

An ultrasound scan of the scrotum is a non-invasive imaging test. It uses sound waves to create pictures of the structures within the lower abdominal area. This helps to assess any discomfort or abnormalities you might be experiencing. The procedure is safe and painless.

12 services12 patients

Complete ultrasound of abdomen and pelvis artery and vein blood flow 93975

This procedure uses sound waves to create images of your abdomen and pelvis, specifically focusing on the arteries and veins. It helps in assessing the blood flow and detecting any abnormalities, ensuring your overall well-being.

11 services11 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Houston Methodist Hospital

Acute Care Hospitals · Houston, TX

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number450358

Location6565 FanninHouston, TX 77030 · Harris County

Emergency services Birthing friendly

Houston Methodist Baytown Hospital

Acute Care Hospitals · Baytown, TX

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number450424

Location4401 Garth RoadBaytown, TX 77521 · Harris County

Emergency services Birthing friendly

Houston Methodist West Hospital

Acute Care Hospitals · Houston, TX

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number670077

Location18500 Katy FreewayHouston, TX 77094 · Harris County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 77030 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

$134.06 typical visit price

range $58.24 – $176.98

Typical copayment $33.51 (range $14.56 – $44.24)

Most-billed visit code 99204

Established Patient

$72.62 typical visit price

range $18.60 – $143.93

Typical copayment $18.15 (range $4.65 – $35.98)

Most-billed visit code 99213

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.

99.15/100

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

Scored as part of a group practice

Promoting Interoperability

Improvement Activities

Reported Quality Measures

Care Plan

Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…

43%1,115 patients2/55-star benchmark: 100%

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

66%2,051 patients1/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

94%3,937 patients4/55-star benchmark: 99%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

62%518 patients1/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

64%1,999 patients3/55-star benchmark: 97%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user

Patients screenedForUse: 87% · 937 patients

84%571 patients4/55-star benchmark: 98%

Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling

Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user

53%571 patients3/55-star benchmark: 100%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

95%1,999 patients4/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…

76%1,999 patients4/55-star benchmark: 89%

Urinary Incontinence: Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older

Percentage of female patients aged 65 years and older who were assessed for the presence or absence of urinary incontinence within 12 months

42%211 patients2/55-star benchmark: 100%

Urinary Incontinence: Plan of Care for Urinary Incontinence in Women Aged 65 Years and Older

Percentage of female patients aged 65 years and older with a diagnosis of urinary incontinence with a documented plan of care for urinary incontinence at least once within 12 months

85%40 patients

View, Download, or Transmit (VDT)

At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.

74%1,999 patients

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 2

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

Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each A4351

DME-Orthotic Devices · category DF008N

5 suppliers20 claims5,220 services$1.43 avg. paid by Medicare

Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, silicone elastomeric, or hydrophilic, etc.), each A4352

DME-Orthotic Devices · category DF008N

1 supplier16 claims3,240 services$6.07 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 3

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

DR. LARA SELTZ MATHESON M.D.

Urology

6560 FANNIN ST STE 1440
HOUSTON, TX 77030

Harris County (713) 790-9700

DR. DAVID WOLFF GOLDFARB MD

Urology

6560 FANNIN ST STE 1440
HOUSTON, TX 77030

Harris County (713) 790-9700

ERIC J HAUFRECT MD PLLC

Obstetrics & Gynecology

6560 FANNIN ST STE 1440
HOUSTON, TX 77030

Harris County (713) 523-7843

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 Sutton's NPI number?

The NPI number for Mark Sutton is 1699769935. It was assigned to this individual provider in the NPPES registry on September 1, 2005.

Where is Mark Sutton located?

Mark Sutton practices at 6560 Fannin St Ste 1440, Houston, TX 77030. The listed phone number is (713) 790-9700.

What is Mark Sutton's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Is Mark Sutton enrolled in Medicare?

Yes. Mark Sutton 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.

What insurance does Mark Sutton accept?

Health plans from Blue Cross and Blue Shield of Texas and UnitedHealthcare list Mark Sutton 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.

Is Mark Sutton affiliated with any hospitals?

According to CMS data, Mark Sutton is affiliated with Houston Methodist Hospital, Houston Methodist Baytown Hospital and Houston Methodist West Hospital.

When was this NPI record last updated?

The NPPES record for Mark Sutton was last updated on April 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.