DR. MARK J VERONNEAU DO
NPI 1932208899
Otolaryngology in Prestonsburg, KY

Q: What is Mark Veronneau's NPI number?

The NPI number for Mark Veronneau is 1932208899. It was assigned to this individual provider in the NPPES registry on September 21, 2006.

Q: What is Mark Veronneau's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Q: When was this NPI record last updated?

The NPPES record for Mark Veronneau was last updated on July 20, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 September 21, 2006PECOS EnrolledAccepts Medicare Assignment

86.86/100

CMS Quality Rating

5322 KY ROUTE 321, SUITE 2, PRESTONSBURG, KY 41653(606) 886-2712(606) 886-2713 Get Directions Write a Review

NPPES record last updated: July 20, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 20, 2022, Apr 16, 2021 (2 updates tracked since 2021).

On this page

About Dr. Mark J Veronneau Do NPPES

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

DR. MARK J VERONNEAU DO (NPI 1932208899) is an individual otolaryngology provider in Prestonsburg, Kentucky, licensed in Kentucky (02996) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS, is affiliated with Highlands Arh Regional Medical Center, and maintains a secondary practice location in Pikeville.

NPPES Registry Identity

NPI1932208899

Entity TypeIndividualMale

Primary Taxonomy207Y00000X

Provider Legal NameDR. MARK J VERONNEAUCredential: DO

Location Address5322 KY ROUTE 321, SUITE 2Prestonsburg, KY 41653-9114

Mailing AddressPo Box 513Staffordsville, KY 41256-0513 · (606) 886-2712 · Fax (606) 886-2713

Phone(606) 886-2712

Fax(606) 886-2713

Sole ProprietorNo

Medical School CMSOhio University, College Of Osteopathic MedicineGraduated 1996

Enumeration DateSeptember 21, 2006

Last NPPES UpdateJuly 20, 20222 updates tracked since enumeration

NPPES CertifiedJuly 20, 2022

✔ NPI 1932208899 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians

Taxonomy Code207Y00000X

License✔ Licensed in KY · 02996

Definition

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.

5322 KY ROUTE 321, Prestonsburg, KY 41653

Open in Google Maps ↗

Secondary Practice Location 1

Location 1911 Bypass Rd Bldg APikeville, KY 41501-1689 · Phone (606) 430-2209 · Fax (606) 218-7509

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter of Tennessee 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

Dr. Mark J Veronneau Do 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 ID5799882924

PECOS Enrollment IDI20070522000504

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

Medicare enrollment records show Mark Veronneau reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Mark Veronneau Plastics & Ent, PLLC

0.3 mi

Otolaryngology

5322 KY ROUTE 321
Prestonsburg, KY 41653

Reassigned Medicare billing, Kentucky enrollment
2 clinicians in this Medicare group

NPI 1316005044 (606) 886-2712

Pikeville Medical Center Inc.

20 mi

Clinic/Center

254 CASSIDY BLVD
Pikeville, KY 41501

Reassigned Medicare billing, Kentucky enrollment
579 clinicians in this Medicare group

NPI 1710207865 (606) 437-0123

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

Areas of Expertise CMS Part B claims 20

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

265 services160 patients

Professional service for multiple injections of allergen 95117

The professional service for multiple injections of allergens involves administering small doses of specific allergens into your body. This is done to help your immune system become less sensitive to them, reducing your allergic reaction over time. It's a safe, effective way to manage allergies.

157 services11 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This 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.

108 services108 patients

Removal of impacted ear wax 69210

Impacted 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.

66 services52 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This 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.

64 services50 patients

Diagnostic exam of voice box using a flexible endoscope 31575

This procedure involves a doctor examining your voice box using a flexible endoscope, a thin tube with a light and camera. It's inserted through your nose or mouth to visualize your throat area. It helps detect any abnormalities in your voice box, ensuring optimal vocal health.

43 services33 patients

Diagnostic exam of nasal passages using an endoscope 31231

A diagnostic exam of nasal passages using an endoscope is a non-invasive procedure. A small, flexible tube with a light and camera at the end, called an endoscope, is inserted into the nose. This allows the doctor to view the nasal passages and sinuses, helping to identify any issues.

31 services20 patients

Comprehensive hearing and speech recognition test 92557

A comprehensive hearing and speech recognition test assesses your ability to hear and understand spoken words. It includes hearing tests to check for issues with sound perception and speech tests to evaluate your word recognition. It's a crucial step in identifying any hearing or speech problems.

28 services28 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

25 services20 patients

Destruction of precancer skin growth, 1 growth 17000

"Destruction of precancer skin growth" is a procedure that eliminates a single precancerous skin growth. This is done to prevent it from developing into skin cancer. The growth may be removed using various methods such as cryotherapy (freezing), laser therapy, or topical medications.

24 services14 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

23 services23 patients

Biopsy of related skin growth, first growth 11102

A biopsy of a skin growth involves taking a small sample of the growth to examine it under a microscope. This helps determine if the growth is harmful. The procedure is typically quick, with minimal discomfort. It's a crucial step in ensuring your skin's health.

17 services17 patients

Diagnostic exam of voice box using a flexible endoscope 31575

16 services14 patients

Test to assess middle ear function 92567

A test to assess middle ear function, also known as an impedance audiometry, helps evaluate how well your middle ear works. It measures the movement of your eardrum in response to changes in air pressure. This can help identify issues like fluid build-up, ear infections, or eardrum perforations.

16 services15 patients

Removal of impacted ear wax 69210

15 services12 patients

Placement of ear probe for computerized measurement of sound with interpretation and report 92587

This procedure involves placing a small probe in your ear to measure sounds. It's a painless process that helps doctors understand your hearing ability. The results will be interpreted and a report will be provided for further assessment.

14 services13 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

13 services13 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

13 services12 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

13 services13 patients

Fine needle aspiration biopsy using ultrasound guidance, first growth 10005

Fine needle aspiration biopsy with ultrasound guidance is a procedure where a thin needle is inserted into a growth to extract a small sample. Ultrasound helps accurately locate the growth. This sample is then analyzed to determine the nature of the growth.

11 services11 patients

Hospital Affiliations CMS Care Compare 2

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

Highlands Arh Regional Medical Center

Acute Care Hospitals · Prestonsburg, KY

2/5 CMS rating

OwnershipProprietary

CMS Certification Number180005

Location5000 Kentucky Route 321Prestonsburg, KY 41653 · Floyd County

Emergency services Birthing friendly

Pikeville Medical Center

Acute Care Hospitals · Pikeville, KY

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number180044

Location911 Bypass RoadPikeville, KY 41501 · Pike County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 41653 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

$122.77 typical visit price

range $52.76 – $162.27

Typical copayment $30.69 (range $13.19 – $40.56)

Most-billed visit code 99204

Established Patient

$66.24 typical visit price

range $16.53 – $131.99

Typical copayment $16.56 (range $4.13 – $32.99)

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

86.86/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

72.39

Promoting Interoperability

100

Improvement Activities

Cost

70.65

Reported Quality Measures

Documentation of Current Medications in the Medical Record

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.

100%303 patients5/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

99%191 patients5/55-star benchmark: 99%

Falls: Screening for Future Fall Risk

Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period

93%668 patients4/55-star benchmark: 99%

Health Information Exchange

The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…

75%133 patients4/55-star benchmark: 88%

Medication Reconciliation

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.

100%164 patients5/55-star benchmark: 100%

Patient-Specific Education

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.

61%294 patients3/55-star benchmark: 97%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

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…

99%2,261 patients5/55-star benchmark: 97%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

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

Patients screenedForUse: 99% · 80 patients

Patients tobacco: 80% · 1,160 patients

64%56 patients3/55-star benchmark: 98%

Provide Patient Access

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…

100%294 patients5/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…

25%1,067 patients2/55-star benchmark: 89%

View, Download, or Transmit (VDT)

At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.

9%294 patients

Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents

Percentage of patients 3-17 years of age who had an outpatient visit with a Primary Care Physician (PCP) or Obstetrician/Gynecologist (OB/GYN) and who had evidence of the following during the measurement period. Three rates are reported.

Patients nutrition: 96% · 529 patients

Patients physicalActivity: 96% · 529 patients

99%529 patients

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 5

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

ARH TUG VALLEY HEALTH SERVICES, INC.

Otolaryngology

5322 KY ROUTE 321
PRESTONSBURG, KY 41653

Floyd County (606) 886-2712

DR. WILLIAM BRIAN HELTON MD

Otolaryngology

5322 KY ROUTE 321
PRESTONSBURG, KY 41653

Floyd County (606) 886-2712

KENTUCKY LAPAROSCOPIC & ADVANCED SURGICAL SPECIALISTS, PLLC

Surgery

5322 KY ROUTE 321, SUITE 1
PRESTONSBURG, KY 41653

Floyd County (606) 886-8240

MARK VERONNEAU PLASTICS & ENT, PLLC

Otolaryngology

5322 KY ROUTE 321
PRESTONSBURG, KY 41653

Floyd County (606) 886-2712

DELISA CAUDILL APRN

Nurse Practitioner

5322 KY ROUTE 321
PRESTONSBURG, KY 41653

Floyd County (606) 886-2712

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 Veronneau's NPI number?

The NPI number for Mark Veronneau is 1932208899. It was assigned to this individual provider in the NPPES registry on September 21, 2006.

Where is Mark Veronneau located?

Mark Veronneau practices at 5322 Ky Route 321 Suite 2, Prestonsburg, KY 41653. The listed phone number is (606) 886-2712.

What is Mark Veronneau's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Is Mark Veronneau enrolled in Medicare?

Yes. Mark Veronneau 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 Veronneau's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mark Veronneau reassigns Medicare benefits to 2 organizations: Mark Veronneau Plastics & Ent, PLLC (Prestonsburg, KY) and Pikeville Medical Center Inc. (Pikeville, KY). 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 Veronneau's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Mark Veronneau accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter of Tennessee, CareSource and Highmark Blue Cross Blue Shield West Virginia list Mark Veronneau 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 Veronneau affiliated with any hospitals?

According to CMS data, Mark Veronneau is affiliated with Highlands Arh Regional Medical Center and Pikeville Medical Center.

When was this NPI record last updated?

The NPPES record for Mark Veronneau was last updated on July 20, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.