DR. MARK F. DEATHERAGE M.D.
NPI 1841293156
Surgery - Vascular Surgery in Grants Pass, OR

Q: What is Mark Deatherage's NPI number?

The NPI number for Mark Deatherage is 1841293156. It was assigned to this individual provider in the NPPES registry on May 31, 2005.

Q: What is Mark Deatherage's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Vascular Surgery, with taxonomy code 2086S0129X.

Q: When was this NPI record last updated?

The NPPES record for Mark Deatherage was last updated on October 17, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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 May 31, 2005PECOS Enrolled

1600 NW 6TH ST, NORTH SUITE, GRANTS PASS, OR 97526(541) 474-5533(541) 476-2380 Get Directions Write a Review

NPPES record last updated: October 17, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Dr. Mark F. Deatherage M.d. NPPES

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

DR. MARK F. DEATHERAGE M.D. (NPI 1841293156) is an individual vascular surgery provider in Grants Pass, Oregon, licensed in Oregon (MD11842) and active in the NPI registry since May 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1841293156

Entity TypeIndividualMale

Primary Taxonomy2086S0129X

Provider Legal NameDR. MARK F. DEATHERAGECredential: M.D.

Location Address1600 NW 6TH ST, NORTH SUITEGrants Pass, OR 97526-1094

Mailing Address1600 Nw 6th St, North SuiteGrants Pass, OR 97526-1094 · (541) 474-5533 · Fax (541) 476-2380

Phone(541) 474-5533

Fax(541) 476-2380

Sole ProprietorNo

Enumeration DateMay 31, 2005

Last NPPES UpdateOctober 17, 2012

✔ NPI 1841293156 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Vascular SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code2086S0129X

License✔ Licensed in OR · MD11842

Definition

A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.

1600 NW 6TH ST, Grants Pass, OR 97526

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Other Identifiers 3

Medicaid024059OR

Medicare UPINE46709OR

Medicare ID-Type Unspecified02WCJLBBOR

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Mark F. Deatherage M.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 97526 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

$84.82 typical visit price

range $54.96 – $166.64

Typical copayment $21.20 (range $13.74 – $41.66)

Most-billed visit code 99203

Established Patient

$68.64 typical visit price

range $17.68 – $136.19

Typical copayment $17.16 (range $4.42 – $34.04)

Most-billed visit code 99213

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 12

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

DEBORAH LYNN ROSSEL NP

Nurse Practitioner (Family)