MARK J FALLEN MD
NPI 1699789719
Urology in Edina, MN

Q: What is Mark Fallen's NPI number?

The NPI number for Mark Fallen is 1699789719. It was assigned to this individual provider in the NPPES registry on July 27, 2006.

Q: What is Mark Fallen'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 Fallen was last updated on November 10, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since July 27, 2006PECOS EnrolledAccepts Medicare Assignment

83.53/100

CMS Quality Rating

6525 FRANCE AVE S, SUITE 200, EDINA, MN 55435(952) 927-6501(952) 653-1435 Get Directions Write a Review

NPPES record last updated: November 10, 2015. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Mark J Fallen Md NPPES

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

MARK J FALLEN MD (NPI 1699789719) is an individual urology provider in Edina, Minnesota, licensed in Minnesota (30919) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Abbott Northwestern Hospital, and is a graduate of Rush Medical College Of Rush University (1986).

NPPES Registry Identity

NPI1699789719

Entity TypeIndividualMale

Primary Taxonomy208800000X

Provider Legal NameMARK J FALLENCredential: MD

Location Address6525 FRANCE AVE S, SUITE 200Edina, MN 55435-2148

Mailing Address6525 France S Ave 200Edina, MN 55435-2176 · (952) 927-6501 · Fax (952) 653-1435

Phone(952) 927-6501

Fax(952) 653-1435

Sole ProprietorNo

Medical School CMSRush Medical College Of Rush UniversityGraduated 1986

Enumeration DateJuly 27, 2006

Last NPPES UpdateNovember 10, 2015

✔ NPI 1699789719 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians

Taxonomy Code208800000X

License✔ Licensed in MN · 30919

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.

6525 FRANCE AVE S, Edina, MN 55435

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Other Identifiers 2

Medicare UPINF20968MN

Medicare PINH400108281MN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica.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 J Fallen 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 ID749347268

PECOS Enrollment IDI20100329001105

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 22

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.

1,200 services12 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.

274 services200 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.

227 services166 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.

212 services179 patients

Psa (prostate specific antigen) measurement, total 84153

PSA measurement is a simple blood test that checks for a specific protein produced by your body. High levels could indicate a health issue that needs further investigation. It's often used to monitor general wellness and is part of routine health screening.

202 services155 patients

Leuprolide acetate (for depot suspension), 7.5 mg J9217

Leuprolide acetate is a medication that helps regulate certain hormone levels in your body. It's injected into your muscle once a month. This treatment can help manage various health conditions related to hormone imbalance. Always follow your doctor's instructions.

192 services25 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.

146 services110 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.

145 services117 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.

108 services94 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.

93 services78 patients

Injection, ceftriaxone sodium, per 250 mg J0696

Ceftriaxone sodium is an antibiotic injection used to treat a variety of bacterial infections. Each injection contains 250 mg of the medicine. It works by stopping the growth of bacteria in your body.

85 services22 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.

42 services41 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.

39 services39 patients

Bacterial colony count, urine 87086

A bacterial colony count, urine, is a laboratory test that checks a urine sample for bacteria. It helps to identify if an infection is present in the urinary system. High numbers of bacteria in the urine can indicate a urinary tract infection (UTI).

37 services31 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.

26 services26 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.

24 services11 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.

24 services18 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.

22 services22 patients

Telephone medical discussion with physician, 11-20 minutes 99442

This is a service where you have a phone conversation with your doctor for 11-20 minutes. It's used for discussing health concerns, reviewing test results, or managing ongoing conditions. It's a convenient way to receive medical advice without an in-person visit.

21 services20 patients

Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), microdilution or agar dilution 87186

This process checks how well certain drugs, like antibiotics, can fight against infections. It involves mixing the drug with a microbe (like bacteria or a virus) in a lab. By observing how the microbe reacts, it helps determine the best drug to treat your infection.

18 services14 patients

Blood creatinine level 82565

A blood creatinine level test measures the amount of creatinine in your blood. Creatinine is a waste product that your body produces when it uses energy. High levels may indicate that your kidneys aren't working properly. This test is often used to monitor kidney health.

16 services16 patients

Bacterial urine culture 87088

A bacterial urine culture is a laboratory test that checks for bacteria in your urine. It helps identify the type of bacteria causing an infection, enabling the selection of the most effective treatment. The test involves collecting a urine sample in a sterile container.

13 services11 patients

Hospital Affiliations CMS Care Compare 2

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

Abbott Northwestern Hospital

Acute Care Hospitals · Minneapolis, MN

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number240057

Location800 East 28th StreetMinneapolis, MN 55407 · Hennepin County

Emergency services Birthing friendly

Buffalo Hospital

Acute Care Hospitals · Buffalo, MN

5/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number240076

Location303 Catlin StreetBuffalo, MN 55313 · Wright County

Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55435 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

$127.61 typical visit price

range $56.00 – $168.28

Typical copayment $31.90 (range $14.00 – $42.07)

Most-billed visit code 99204

Established Patient

$69.74 typical visit price

range $18.32 – $138.04

Typical copayment $17.43 (range $4.58 – $34.51)

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.

83.53/100

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

Scored as part of a group practice

Quality

81.79

Promoting Interoperability

100

Improvement Activities

Cost

63.31

Reported Quality Measures

Closing the Referral Loop: Receipt of Specialist Report

52%31 patients3/55-star benchmark: 87%

Colorectal Cancer Screening

63%645 patients3/55-star benchmark: 88%

Documentation of Current Medications in the Medical Record

96%1,578 patients4/55-star benchmark: 100%

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

Patients combinedPopulations: 96% · 442 patients

Patients screened: 99% · 442 patients

27%22 patients2/55-star benchmark: 100%

Provide Patients Electronic Access to Their Health Information

85%400 patients4/55-star benchmark: 100%

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 0% · 706 patients

Patients totalRate: 1% · 706 patients

1%706 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

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

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

DME-Orthotic Devices · category DF008N

10 suppliers111 claims13,066 services$5.21 avg. paid by Medicare

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

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Other Providers at the Same Location NPPES 20

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

FAIRVIEW CLINICS

Obstetrics & Gynecology

6525 FRANCE AVE S, SUITE 100
EDINA, MN 55435

Hennepin County (952) 285-6140

UROLOGY ASSOCIATES, LTD.

Urology

6525 FRANCE AVE S, SUITE 200
EDINA, MN 55435

Hennepin County (952) 927-6501

DR. THOMAS ARTHUR RIVERS M.D.

Urology

6525 FRANCE AVE S, SUITE 200
EDINA, MN 55435

Hennepin County (952) 927-6501

DR. RANDOLPH K. PETERSON M.D.

Pathology (Anatomic Pathology & Clinical Pathology)

6525 FRANCE AVE S, SUITE 200
EDINA, MN 55435

Hennepin County (952) 927-6501

THOMAS H AYRE M.D.

Otolaryngology

6525 FRANCE AVE S, SUITE 325
EDINA, MN 55435

Hennepin County (952) 920-4595

UROLOGY ASSOCIATES, LTD.

Urology

6525 FRANCE AVE S, SUITE 200
EDINA, MN 55435

Hennepin County (952) 927-6501

KATHERINE MIA CHOI MD

Obstetrics & Gynecology

6525 FRANCE AVE S
EDINA, MN 55435

Hennepin County (612) 273-7111

DR. WILLIAM JOSEPH UTZ M.D.

Urology

6525 FRANCE AVE S, SUITE 200
EDINA, MN 55435

Hennepin County (952) 927-6501

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 Fallen's NPI number?

The NPI number for Mark Fallen is 1699789719. It was assigned to this individual provider in the NPPES registry on July 27, 2006.

Where is Mark Fallen located?

Mark Fallen practices at 6525 France Ave S Suite 200, Edina, MN 55435. The listed phone number is (952) 927-6501.

What is Mark Fallen's specialty?

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

Is Mark Fallen enrolled in Medicare?

Yes. Mark Fallen 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 Fallen accept?

Health plans from Medica list Mark Fallen 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 Fallen affiliated with any hospitals?

According to CMS data, Mark Fallen is affiliated with Abbott Northwestern Hospital and Buffalo Hospital.

When was this NPI record last updated?

The NPPES record for Mark Fallen was last updated on November 10, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.