MARK CONNAR EASTBURG PH.D.
NPI 1780610634
Psychologist - Clinical in Grand Rapids, MI

Q: What is Mark Eastburg's NPI number?

The NPI number for Mark Eastburg is 1780610634. It was assigned to this individual provider in the NPPES registry on June 23, 2006.

Q: What is Mark Eastburg's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: When was this NPI record last updated?

The NPPES record for Mark Eastburg was last updated on November 17, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since June 23, 2006PECOS Enrolled

300 68TH ST SE, GRAND RAPIDS, MI 49548(616) 455-5000 Get Directions Write a Review

NPPES record last updated: November 17, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 17, 2022, Sep 8, 2022, Aug 26, 2022 and 1 more (4 updates tracked since 2020).

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About Mark Connar Eastburg Ph.d. NPPES

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

MARK CONNAR EASTBURG PH.D. (NPI 1780610634) is an individual clinical provider in Grand Rapids, Michigan, licensed in Michigan (6301008255) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1780610634

Entity TypeIndividualMale

Primary Taxonomy103TC0700X

Provider Legal NameMARK CONNAR EASTBURGCredential: PH.D.

Location Address300 68TH ST SEGrand Rapids, MI 49548-6927

Mailing Address300 68th St SeGrand Rapids, MI 49548-6927 · (616) 455-5000

Phone(616) 455-5000

Sole ProprietorNo

Enumeration DateJune 23, 2006

Last NPPES UpdateNovember 17, 20224 updates tracked since enumeration

NPPES CertifiedNovember 17, 2022

✔ NPI 1780610634 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in MI · 6301008255

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Also ListedPsychologistTaxonomy 103T00000X · License 6301008255 (MI)

300 68TH ST SE, Grand Rapids, MI 49548

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Other Identifiers 1

OtherD16189031MI · Bc/bs

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Priority Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mark Connar Eastburg Ph.d. 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49548 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

$166.68 typical visit price

range $54.34 – $166.68

Typical copayment $41.67 (range $13.58 – $41.67)

Most-billed visit code 99205

Established Patient

$96.44 typical visit price

range $17.09 – $135.40

Typical copayment $24.11 (range $4.27 – $33.85)

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.

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