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MARK RICHARD IPPOLITO M.D.
NPI 1720042179
Psychiatry & Neurology - Neurology in Charlotte, NC

Active since April 13, 2006PECOS EnrolledAccepts Medicare Assignment
200 HAWTHORNE LN, CHARLOTTE, NC 28204(704) 384-9437(704) 384-9440 Get Directions Write a Review

NPPES record last updated: October 25, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 25, 2020, Apr 30, 2019 (2 updates tracked since 2019).

About Mark Richard Ippolito M.d. NPPES

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

MARK RICHARD IPPOLITO M.D. (NPI 1720042179) is an individual neurology provider in Charlotte, North Carolina, licensed in North Carolina (2000-00076) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS, is affiliated with St James Healthcare, and maintains a secondary practice location in Charlotte.

NPPES Registry Identity

NPI1720042179
Entity TypeIndividualMale
Primary Taxonomy2084N0400X
Provider Legal NameMARK RICHARD IPPOLITOCredential: M.D.
Location Address200 HAWTHORNE LNCharlotte, NC 28204-2515
Mailing AddressPo Box 60447Charlotte, NC 28260-0447 · (704) 384-7840 · Fax (704) 384-7830
Phone(704) 384-9437
Fax(704) 384-9440
Sole ProprietorNo
Medical School CMSState University Of New York At Buffalo School Of MedicineGraduated 1992
Enumeration DateApril 13, 2006
Last NPPES UpdateOctober 25, 20202 updates tracked since enumeration
NPPES CertifiedSeptember 25, 2020
✔ NPI 1720042179 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0400X
License✔ Licensed in NC · 2000-00076
Definition
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
Also ListedPsychiatry & Neurology · Sleep MedicineTaxonomy 2084S0012X · License 2000-00076 (NC)
200 HAWTHORNE LN, Charlotte, NC 28204
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Secondary Practice Location 1

Location 11918 Randolph Rd, Suite 400Charlotte, NC 28207-1100 · Phone (704) 384-9437 · Fax (704) 384-9440

Other Identifiers 1

Medicaid8912769NC

Accepted Insurance

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

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

Mark Richard Ippolito M.d. 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 ID648249805
PECOS Enrollment IDI20241226002426
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 Reassignments

6

Medicare enrollment records show Mark Ippolito reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Access Telecare California, P.C.
931 mi
Neurology
1717 MAIN ST STE 5850
Dallas, TX 75201
  • Reassigned Medicare billing, North Carolina enrollment
  • Medicare enrollment name: Access Telecare California PC
  • 5 clinicians in this Medicare group
NPI 1861959959 (972) 449-0540
Access Telecare, PLLC
931 mi
Internal Medicine
1717 MAIN ST STE 5850
Dallas, TX 75201
  • Reassigned Medicare billing, North Carolina enrollment
  • 240 clinicians in this Medicare group
NPI 1013303080 (972) 449-0540
Holy Rosary Healthcare
1,512 mi
Clinic/Center
2600 WILSON ST
Miles City, MT 59301
  • Reassigned Medicare billing, Montana enrollment
  • 88 clinicians in this Medicare group
NPI 1225201825 (406) 233-2500
St Vincent Healthcare
1,577 mi
Family Medicine
16 N MILES AVE
Hardin, MT 59034
  • Reassigned Medicare billing, Montana enrollment
  • Medicare enrollment name: Scl Health Montana
  • 186 clinicians in this Medicare group
NPI 1043266109 (406) 665-2205
Scl Health Medical Group - Billings, LLC
1,619 mi
General Practice
32 WICKS LN
Billings, MT 59105
  • Reassigned Medicare billing, Montana enrollment
  • 438 clinicians in this Medicare group
NPI 1447866538 (406) 237-8400
Scl Health Medical Group-Butte LLC
1,795 mi
Rural Health
214 S MAIN ST
Boulder, MT 59632
  • Reassigned Medicare billing, Montana enrollment
  • 278 clinicians in this Medicare group
NPI 1861031122 (406) 225-4201

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

Hospital Affiliations CMS Care Compare 2

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

St James Healthcare

Acute Care Hospitals · Butte, MT
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number270017
Location400 S Clark StButte, MT 59701 · Silver Bow County
Emergency services Birthing friendly

St Vincent Healthcare

Acute Care Hospitals · Billings, MT
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number270049
Location1233 N 30th StBillings, MT 59101 · Yellowstone County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28204 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
$125.01 typical visit price
range $54.12 – $165.09
Typical copayment $31.25 (range $13.53 – $41.27)
Most-billed visit code 99204
Established Patient
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
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.

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.

WELO SYLVIE OLENGA CRNA
Nurse Anesthetist, Certified Registered
200 HAWTHORNE LN
CHARLOTTE, NC 28204
Mecklenburg County (704) 384-4239
MRS. ADRIENNE DUNLAP LANE
Nurse Practitioner (Neonatal)
200 HAWTHORNE LN
CHARLOTTE, NC 28204
Mecklenburg County (704) 384-4109
RYAN ALAN WILLIAMSON M.D.
Psychiatry & Neurology (Neurology)
200 HAWTHORNE LN
CHARLOTTE, NC 28204
Mecklenburg County (704) 384-9437
CHRISSY LATONYA HARRIS AGACNP
Nurse Practitioner (Critical Care Medicine)
200 HAWTHORNE LN
CHARLOTTE, NC 28204
Mecklenburg County (704) 384-4000
JAYME-JO KINNEY
Pharmacist (Pharmacotherapy)
200 HAWTHORNE LN
CHARLOTTE, NC 28204
Mecklenburg County (704) 384-4840
EDEN TEDLA PA-C
Physician Assistant
200 HAWTHORNE LN
CHARLOTTE, NC 28204
Mecklenburg County (704) 384-5416
MATTHEW WYNNE SPANGLER MD
Pediatrics
200 HAWTHORNE LN
CHARLOTTE, NC 28204
Mecklenburg County (704) 384-4021
RAVEN DANIELLE LYLES
Nurse Anesthetist, Certified Registered
200 HAWTHORNE LN
CHARLOTTE, NC 28204
Mecklenburg County (704) 384-4274

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 Ippolito's NPI number?

The NPI number for Mark Ippolito is 1720042179. It was assigned to this individual provider in the NPPES registry on April 13, 2006.

Where is Mark Ippolito located?

Mark Ippolito practices at 200 Hawthorne Ln, Charlotte, NC 28204. The listed phone number is (704) 384-9437.

What is Mark Ippolito's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

Is Mark Ippolito enrolled in Medicare?

Yes. Mark Ippolito 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 organizations bill Medicare for Mark Ippolito's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mark Ippolito reassigns Medicare benefits to 6 organizations: Access Telecare California, P.C. (Dallas, TX), Access Telecare, PLLC (Dallas, TX), Holy Rosary Healthcare (Miles City, MT), St Vincent Healthcare (Hardin, MT), Scl Health Medical Group - Billings, LLC (Billings, MT) and 1 more organization, listed in the Medicare section above. Each 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 Mark Ippolito's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Mark Ippolito accept?

Health plans from Arkansas Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Texas, Cigna Healthcare and Health Advantage and 4 other insurers list Mark Ippolito 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 Ippolito affiliated with any hospitals?

According to CMS data, Mark Ippolito is affiliated with St James Healthcare and St Vincent Healthcare.

When was this NPI record last updated?

The NPPES record for Mark Ippolito was last updated on October 25, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.