DR. MARK DOUGLAS HUGHES MD
NPI 1700870847
Internal Medicine - Gastroenterology in Sebastian, FL

Q: What is Mark Hughes's NPI number?

The NPI number for Mark Hughes is 1700870847. It was assigned to this individual provider in the NPPES registry on September 6, 2005.

Q: What is Mark Hughes's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Q: When was this NPI record last updated?

The NPPES record for Mark Hughes was last updated on August 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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 06, 2005PECOS EnrolledAccepts Medicare Assignment

85.38/100

CMS Quality Rating

12920 US HIGHWAY 1 STE B, SEBASTIAN, FL 32958(772) 589-0580(321) 841-7985 Get Directions Write a Review

NPPES record last updated: August 9, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 9, 2025, Dec 5, 2024, May 9, 2024 and 3 more (6 updates tracked since 2016).

On this page

About Dr. Mark Douglas Hughes Md NPPES

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

DR. MARK DOUGLAS HUGHES MD (NPI 1700870847) is an individual gastroenterology provider in Sebastian, Florida, licensed in Florida (ME113291) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS, is affiliated with Sebastian River Medical Center, and maintains a secondary practice location in Rockledge.

NPPES Registry Identity

NPI1700870847

Entity TypeIndividualMale

Primary Taxonomy207RG0100X

Provider Legal NameDR. MARK DOUGLAS HUGHESCredential: MD

Location Address12920 US HIGHWAY 1 STE BSebastian, FL 32958-3772

Mailing Address12920 Us Highway 1 Ste BSebastian, FL 32958-3772 · (772) 589-0580 · Fax (321) 841-7985

Phone(772) 589-0580

Fax(321) 841-7985

Sole ProprietorNo

Medical School CMSUniversity Of Louisville School Of MedicineGraduated 1990

Enumeration DateSeptember 6, 2005

Last NPPES UpdateAugust 9, 20256 updates tracked since enumeration

NPPES CertifiedAugust 9, 2025

✔ NPI 1700870847 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

License✔ Licensed in FL · ME113291

Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

12920 US HIGHWAY 1 STE B, Sebastian, FL 32958

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Secondary Practice Location 1

Location 11846 Highway 1Rockledge, FL 32955-2822 · Phone (321) 434-9560 · Fax (321) 434-7078

Other Identifiers 2

Medicaid005799500FL

OtherGE682YFL · Medicare

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, Ambetter of Alabama and more.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

Dr. Mark Douglas Hughes 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 ID9638265853

PECOS Enrollment IDI20120626000560

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 14

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.

Biopsy of large bowel using a flexible endoscope 45380

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

181 services179 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

162 services158 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

140 services138 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.

101 services88 patients

Injection beneath lining of large bowel using a flexible endoscope 45381

This procedure involves a flexible tube, called an endoscope, being inserted into the large bowel. A small needle is then passed through the tube to inject medication under the bowel lining. This is typically done to treat inflammation or bleeding.

43 services43 patients

Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, less than 3.0 cm 43249

This procedure involves using a flexible tube with a camera, called an endoscope, to gently expand narrowed areas in your esophagus, stomach, or upper small bowel. A small balloon is inflated, making it easier for food and liquid to pass through. It's safe and effective.

37 services33 patients

Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43235

This procedure, known as an upper endoscopy, involves inserting a thin, flexible tube with a camera down the throat to examine the esophagus, stomach, and upper small bowel. It helps diagnose conditions like ulcers or inflammation.

34 services33 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.

30 services30 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.

30 services29 patients

Colorectal cancer screening; colonoscopy on individual at high risk G0105

Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.

25 services25 patients

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

23 services11 patients

Diagnostic exam of large bowel using a flexible endoscope 45378

This procedure, known as a colonoscopy, involves using a flexible tube with a light and camera to examine the large intestine. It helps detect any abnormalities such as polyps or inflammation. It's a standard procedure to ensure gut health.

14 services14 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.

14 services14 patients

Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk G0121

Colorectal cancer screening, such as a colonoscopy, is a preventive measure to detect early signs of cancer in the large intestine. For individuals not at high risk, it's typically recommended at age 50. A small, flexible tube with a camera is used to examine your colon. It's a safe, effective way to catch issues early.

11 services11 patients

Hospital Affiliations CMS Care Compare 2

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

Sebastian River Medical Center

Acute Care Hospitals · Sebastian, FL

3/5 CMS rating

OwnershipProprietary

CMS Certification Number100217

Location13695 Us Hwy 1Sebastian, FL 32958 · Indian River County

Emergency services

Viera Hospital

Acute Care Hospitals · Melbourne, FL

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100315

Location8745 N Wickham RdMelbourne, FL 32940 · Brevard County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32958 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

$135.56 typical visit price

range $58.56 – $179.05

Typical copayment $33.89 (range $14.64 – $44.76)

Most-billed visit code 99204

Established Patient

$103.21 typical visit price

range $18.44 – $144.68

Typical copayment $25.80 (range $4.61 – $36.17)

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.

85.38/100

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

Scored through an Alternative Payment Model

Quality

81.65

Promoting Interoperability

Improvement Activities

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.

Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4034

Other-Enteral and Parenteral · category OB006N

2 suppliers12 claims367 services$2.72 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

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

STEWARD MEDICAL GROUP, INC

Otolaryngology

12920 US HIGHWAY 1 STE B
SEBASTIAN, FL 32958

Indian River County (772) 228-9808

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 Hughes's NPI number?

The NPI number for Mark Hughes is 1700870847. It was assigned to this individual provider in the NPPES registry on September 6, 2005.

Where is Mark Hughes located?

Mark Hughes practices at 12920 Us Highway 1 Ste B, Sebastian, FL 32958. The listed phone number is (772) 589-0580.

What is Mark Hughes's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Mark Hughes enrolled in Medicare?

Yes. Mark Hughes 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 Hughes accept?

Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Ambetter of Alabama, AvMed and Florida Blue (BlueCross BlueShield FL) and 2 other insurers list Mark Hughes 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 Hughes affiliated with any hospitals?

According to CMS data, Mark Hughes is affiliated with Sebastian River Medical Center and Viera Hospital.

When was this NPI record last updated?

The NPPES record for Mark Hughes was last updated on August 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.