DR. MARK LEE CAPENER M.D.
NPI 1750489100
Otolaryngology in Idaho Falls, ID
NPI Status: Active since September 20, 2006
Contact Information
2065 E 17TH ST
SUITE B-2
IDAHO FALLS, ID
ZIP 83404
Phone: (208) 524-7244
Fax: (208) 524-1088
- Individual
- Male
- Years of Experience 33
- Otolaryngology
- Accepts Insurance
- May Accept Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About MARK CAPENER
This page provides the complete NPI Profile along with additional information for Mark Capener, a provider established in Idaho Falls, Idaho with a medical specialization in Otolaryngology and more than 33 years of experience. He graduated from Eastern Virginia Medical School in 1993. The healthcare provider is registered in the NPI registry with number 1750489100 assigned on September 2006. The practitioner's primary taxonomy code is 207Y00000X with license number 8394 (ID). The provider is registered as an individual and his NPI record was last updated 17 years ago.
- NPI
- 1750489100
- Provider Name
- DR. MARK LEE CAPENER M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 2065 E 17TH ST SUITE B-2 IDAHO FALLS, ID 83404
- Location Phone
- (208) 524-7244
- Location Fax
- (208) 524-1088
- Mailing Address
- 2065 E 17TH ST SUITE B-2 IDAHO FALLS, ID 83404
- Mailing Phone
- (208) 524-7244
- Mailing Fax
- (208) 524-1088
- Medical School Name
- EASTERN VIRGINIA MEDICAL SCHOOL
- Graduation Year
- 1993
- Is Sole Proprietor?
- No
- Enumeration Date
- 09-20-2006
- Last Update Date
- 05-22-2008
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Otolaryngology
- Taxonomy Code
- 207Y00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 8394
- License State
- ID
- Taxonomy Description
- An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Connect Bronze Expanded Standard - PPO
- Connect Bronze HDHP - PPO
- Connect Catastrophic - PPO
- Connect Gold - PPO
- Connect Gold Standard - PPO
- Connect Silver - PPO
- Connect Silver Standard - PPO
- High Plains Bronze HDHP - PPO
- High Plains Bronze Standard Expanded - PPO
- High Plains Gold - PPO
- High Plains Gold HDHP - PPO
- High Plains Gold Standard - PPO
- High Plains Silver - PPO
- High Plains Silver Standard - PPO
- Plus Bronze Expanded - PPO
- Plus Bronze Standard Expanded - PPO
- Plus Gold - PPO
- Plus Gold Standard - PPO
- Plus Silver Standard - PPO
- ACCESS BRONZE - PPO
- Navigator Bronze 7000 Exchange - PPO
- Navigator Bronze 9200 - PPO
- Navigator Bronze HSA 8050 - PPO
- Navigator Gold 1500 - PPO
- Navigator Gold 1500 Exchange - PPO
- Navigator Gold 500 Exchange - PPO
- Navigator Silver 3500 Exchange - PPO
- Navigator Silver 4000 Exchange - PPO
- Navigator Silver 5000 - PPO
- Navigator Silver HSA 3500 - PPO
- Navigator Standard Expanded Bronze - PPO
- Navigator Standard Gold - PPO
- Navigator Standard Silver - PPO
- PacificSource Oregon Standard Bronze Plan NAV - PPO
- PacificSource Oregon Standard Gold Plan NAV - PPO
- PacificSource Oregon Standard Silver Plan NAV - PPO
- Healthy Premier Bronze HSA - EPO
- Healthy Premier Expanded Bronze Standard - EPO
- Healthy Premier Gold Copay - EPO
- Healthy Premier Gold Standard - EPO
- Healthy Premier Silver Copay - EPO
- Healthy Premier Silver Standard - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| F90674 | MEDICARE UPIN (02) | ID | |
| 805970200 | MEDICAID (05) | ID | |
| 1105005 | MEDICARE PIN (08) | ID |
Medicare Participation & PECOS Enrollment Status
Mark Capener is registered with Medicare but maybe doesn't accept claims assignment. If you are a Medicare beneficiary call and confirm with the provider before seeking any services.
Mark Capener is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 4183711641
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20071030000540
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Maybe
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Oxygen and Supplies (DC002N)
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)
2 DME suppliers used 26 Medicare Claims 27 Services Paid
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Biopsy or removal of nasal polyp or tissue using an endoscope
Complete exam of nose and sinuses using an endoscope
Computer-assisted procedure outside membrane covering brain
Diagnostic exam of lung airway using an endoscope
Established patient office or other outpatient visit, 30-39 minutes
Injection of drug or substance under skin or into muscle
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg
Melanoma (skin cancer) excision
New patient office or other outpatient visit, 30-44 minutes
Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing
Removal of impacted ear wax
Removal of nasal air passage under lining tissue
Removal of nasal sinus tissue using an endoscope
Removal of sphenoid nasal sinus tissue using an endoscope
Upper gastrointestinal (GI) endoscopy for acid reflux
A nasal biopsy or polyp removal is a procedure where an endoscope, a thin tube with a light and camera, is inserted into the nose. This allows the doctor to see and remove abnormal tissues or polyps, which are small growths. This procedure helps diagnose or treat nasal issues.
This service was performed 26 times for 13 patientsThis procedure involves inserting a thin tube with a light (endoscope) into the nose to examine the nasal passages and sinuses. It helps identify any abnormalities or issues. The process is safe, usually painless, and provides valuable information for your care.
This service was performed 15 times for 15 patientsA computer-assisted procedure outside the brain's membrane involves using advanced technology to help doctors accurately navigate and perform operations near the brain. This method enhances precision, safety, and effectiveness, potentially reducing recovery time.
This service was performed 15 times for 15 patientsThis procedure involves a doctor inserting a thin, flexible tube called an endoscope into your lung airway. It allows the doctor to view the airway and diagnose any issues. The process is safe and helps in accurate diagnosis.
This service was performed 12 times for 11 patientsThis 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.
This service was performed 399 times for 107 patientsThis 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.
This service was performed 101 times for 24 patientsThis is a procedure where a small dose of Vitamin B-12, also known as Cyanocobalamin, is injected into your body. This vitamin is essential for nerve function and the production of red blood cells. It's often used to treat vitamin B-12 deficiency.
This service was performed 108 times for 25 patientsMelanoma excision is a procedure where a surgeon removes melanoma, a type of skin cancer, and some surrounding healthy tissue. Local anesthesia is applied to numb the area. The goal is to completely remove the cancer and prevent its spread. Healing time varies.
This service was performed for 1-10 patientsThis 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.
This service was performed 45 times for 45 patientsThis procedure involves a doctor removing impacted earwax (cerumen) from one or both ears. This is often done on the same day as hearing function tests. The process helps to clear the ear canal, improving hearing and ensuring accurate test results.
This service was performed 38 times for 21 patientsImpacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.
This service was performed 23 times for 17 patientsThis procedure, often done to improve breathing or address sinus issues, involves the removal of tissue from the lining of the nasal air passage. It's performed under anesthesia and recovery time varies based on individual health status.
This service was performed 16 times for 16 patientsThis procedure, known as endoscopic sinus surgery, involves using a thin, flexible tube with a light and camera to view and remove problematic nasal sinus tissue. It helps to alleviate sinus issues and improve breathing.
This service was performed 15 times for 15 patientsThis procedure involves the use of a small camera, called an endoscope, to view and remove tissue from the sphenoid sinus, located in the nasal cavity. It's a minimally invasive method to address issues like sinusitis or polyps.
This service was performed 17 times for 17 patientsAn upper GI endoscopy is a procedure to examine your esophagus and stomach using a thin, flexible tube called an endoscope. It helps diagnose conditions like acid reflux by identifying any inflammation or damage. It's generally safe, performed under sedation, and takes about 15-30 minutes.
This service was performed for 11 patientsPhysician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 83404 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $121.27
- Minimum New Patient Price $52.44
- Maximum New Patient Price $160.17
- Average New Patient Copayment $30.31
- Minimum New Patient Copayment $13.11
- Maximum New Patient Copayment $40.04
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $65.77
- Minimum Established Patient Price $16.68
- Maximum Established Patient Price $130.93
- Average Established Patient Copayment $16.44
- Minimum Established Patient Copayment $4.17
- Maximum Established Patient Copayment $32.73
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Adult Sinusitis: Antibiotic Prescribed for Acute Viral Sinusitis (Overuse) | 4% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better. | 200 |
| Percentage of patients, aged 18 years and older, with a diagnosis of acute viral sinusitis who were prescribed an antibiotic within 10 days after onset of symptoms | ||
| Care Plan | 93% | 286 |
| 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 or provide an advance care plan | ||
| Documentation of Current Medications in the Medical Record | 99% | 3716 |
| 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. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration | ||
| Engagement of New Medicaid Patients and Follow-up | Yes | N/A |
| Seeing new and follow-up Medicaid patients in a timely manner, including individuals dually eligible for Medicaid and Medicare. A timely manner is defined as within 10 business days for this activity. | ||
| e-Prescribing | 76% | 1393 |
| At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
| Medication Reconciliation | 95% | 966 |
| 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. | ||
| Patient-Specific Education | 23% | 459 |
| 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. | ||
| Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 7% | 828 |
| Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2 | ||
| Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 10% | 90 |
| 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 | ||
| Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling | 56% | 616 |
| 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 | ||
| Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical Record | Yes | N/A |
| • Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following: • Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care); • Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/or Provision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management. | ||
| Provide Patient Access | 30% | 459 |
| 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 certain information. | ||
| Security Risk Analysis | Yes | N/A |
| Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. | ||
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Mark Capener is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| MOUNTAIN VIEW HOSPITAL | 2325 CORONADO STREET IDAHO FALLS, ID 83404 | (208) 557-2700 | Acute Care Hospitals |
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 7 | 5 | 0 | 4 | 8 | 9 | 1 | 0 | 0 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 7 | 10 | 0 | 8 | 8 | 18 | 1 | 0 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 7 + 1 + 0 + 0 + 8 + 8 + 1 + 8 + 1 + 0 + 24 = 60 | |||||||||
| Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
| 0 | |||||||||
The NPI number 1750489100 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 16 providers are registered at the same or nearby location.
ALPINE EAR, NOSE & THROAT, P.C
Otolaryngology
(Otolaryngology/Facial Plastic Surgery)
2065 E 17TH ST
SUITE B
IDAHO FALLS, ID
ZIP 83404
IVY A. HANSEN P.A.-C.
Physician Assistant
(Medical)
2065 E 17TH ST
SUITE D
IDAHO FALLS, ID
ZIP 83404
JULIAN DEBRUYNKOPS MD PA
Family Medicine
2065 E 17TH ST
SUITE C
IDAHO FALLS, ID
ZIP 83404
MRS. MOLLY SUSAN PHILLIPP C.R.N.P.
Nurse Practitioner
(Obstetrics & Gynecology)
2065 E 17TH ST
SUITE D
IDAHO FALLS, ID
ZIP 83404
DR. DANIEL K HINCKLEY M.D.
Specialist
2065 E 17TH ST
SUITE A
IDAHO FALLS, ID
ZIP 83404
DANIEL K HINCKLEY MD PA
Specialist
2065 E 17TH ST
ST A
IDAHO FALLS, ID
ZIP 83404
DR. GENE K. HODGES M.D.
Family Medicine
(Adult Medicine)
2065 E 17TH ST
SUITE A
IDAHO FALLS, ID
ZIP 83404
DR. R. DOUGLAS ISBELL M.D.
Obstetrics & Gynecology
2065 E 17TH ST
SUITE D
IDAHO FALLS, ID
ZIP 83404
MRS. REBECCA A. WESTERGARD P.A.
Physician Assistant
(Medical)
2065 E 17TH ST
SUITE D
IDAHO FALLS, ID
ZIP 83404
GENE K. HODGES M.D.
Family Medicine
(Adult Medicine)
2065 E 17TH ST
SUITE A
IDAHO FALLS, ID
ZIP 83404
GENE K. HODGES M.D.
Family Medicine
2065 E 17TH ST
SUITE A
IDAHO FALLS, ID
ZIP 83404
BOYD L HAMMOND MD PA
Surgery
2065 E 17TH ST
SUITE A
IDAHO FALLS, ID
ZIP 83404
OBSTETRICS AND GYNECOLOGY ASSOCIATES OF IDAHO FALLS
Obstetrics & Gynecology
2065 E 17TH ST
SUITE D
IDAHO FALLS, ID
ZIP 83404
ALISHA SCOTT PA-C
Physician Assistant
2065 E 17TH ST
IDAHO FALLS, ID
ZIP 83404
LISA MARIE BURGER ACAGNP-C
Nurse Practitioner
(Adult Health)
2065 E 17TH ST
IDAHO FALLS, ID
ZIP 83404
RACHEL VOSS NP
Nurse Practitioner
(Family)
2065 E 17TH ST
IDAHO FALLS, ID
ZIP 83404
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1750489100, enumerated as an "individual" on September 20, 2006.
The provider is located at 2065 E 17TH ST SUITE B-2 IDAHO FALLS, ID 83404 and the phone number is (208) 524-7244.
Otolaryngology with taxonomy code 207Y00000X.
The provider might be accepting Accepts: Mountain Health CO-OP, PacificSource Health Plans,. Please consult your insurance carrier or call the provider to verify.
Mark Capener is affiliated with: MOUNTAIN VIEW HOSPITAL.
