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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MR. MARK ALAN LOGAN PMHNP-BC
NPI 1780107433
Nurse Practitioner - Psychiatric/Mental Health in Flagstaff, AZ

Active since July 24, 2017PECOS Enrolled
3596 W ALTAIR WAY, FLAGSTAFF, AZ 86001(913) 634-1341 Get Directions Write a Review

NPPES record last updated: October 8, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Oct 8, 2026, Oct 5, 2023, Sep 7, 2023 and 9 more (12 updates tracked since 2017).

About Mr. Mark Alan Logan Pmhnp-bc NPPES

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

MR. MARK ALAN LOGAN PMHNP-BC (NPI 1780107433) is an individual psychiatric/mental health provider in Flagstaff, Arizona, licensed in Arizona (316036) and active in the NPI registry since July 2017. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1780107433
Entity TypeIndividualMale
Primary Taxonomy363LP0808X
Provider Legal NameMR. MARK ALAN LOGANCredential: PMHNP-BC
Location Address3596 W ALTAIR WAYFlagstaff, AZ 86001-2075
Mailing Address3596 W Altair WayFlagstaff, AZ 86001-2075 · (913) 634-1341
Phone(913) 634-1341
Sole ProprietorYes
Enumeration DateJuly 24, 2017
Last NPPES UpdateOctober 8, 202612 updates tracked since enumeration
NPPES CertifiedOctober 8, 2026
✔ NPI 1780107433 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in AZ · 316036
3596 W ALTAIR WAY, Flagstaff, AZ 86001
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Mark Alan Logan Pmhnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Reassignment

Medicare enrollment records show Mark Logan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Grow Healthcare Group PC
588 mi
Mental Health
99 S ALMADEN BLVD STE 600
San Jose, CA 95113
  • Reassigned Medicare billing, California enrollment
  • 3,139 clinicians in this Medicare group
NPI 1154994846 (408) 402-4385

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 86001 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
$85.89 typical visit price
range $55.44 – $168.60
Typical copayment $21.47 (range $13.86 – $42.15)
Most-billed visit code 99203
Established Patient
$98.00 typical visit price
range $17.72 – $137.41
Typical copayment $24.50 (range $4.43 – $34.35)
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.

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 Logan's NPI number?

The NPI number for Mark Logan is 1780107433. It was assigned to this individual provider in the NPPES registry on July 24, 2017.

Where is Mark Logan located?

Mark Logan practices at 3596 W Altair Way, Flagstaff, AZ 86001. The listed phone number is (913) 634-1341.

What is Mark Logan's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Mark Logan enrolled in Medicare?

Yes. Mark Logan is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Mark Logan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mark Logan reassigns Medicare benefits to Grow Healthcare Group PC (San Jose, CA). The 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 Logan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Mark Logan was last updated on October 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 36 days 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.