DR. MARK KAPLAN MD
NPI 1942442967
Internal Medicine in Cleveland, OH

Q: What is Mark Kaplan's NPI number?

The NPI number for Mark Kaplan is 1942442967. It was assigned to this individual provider in the NPPES registry on April 6, 2009.

Q: What is Mark Kaplan's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Mark Kaplan was last updated on August 25, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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 April 06, 2009PECOS EnrolledAccepts Medicare Assignment

75/100

CMS Quality Rating

30680 BAINBRIDGE RD, CLEVELAND, OH 44139(440) 542-5025(440) 542-5005 Get Directions Write a Review

NPPES record last updated: August 25, 2015. Verified against the NPPES registry weekly; last sync: October 18, 2026.

On this page

About Dr. Mark Kaplan Md NPPES

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

DR. MARK KAPLAN MD (NPI 1942442967) is an individual internal medicine provider in Cleveland, Ohio, licensed in Ohio (35.095291) and active in the NPI registry since April 2009. He is enrolled in Medicare PECOS, is affiliated with Mercy Regional Medical Center, and is a graduate of Other (1992).

NPPES Registry Identity

NPI1942442967

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameDR. MARK KAPLANCredential: MD

Location Address30680 BAINBRIDGE RDCleveland, OH 44139-2282

Mailing Address30680 Bainbridge RdCleveland, OH 44139-2282 · (440) 542-5025 · Fax (440) 542-5005

Phone(440) 542-5025

Fax(440) 542-5005

Sole ProprietorNo

Medical School CMSOtherGraduated 1992

Enumeration DateApril 6, 2009

Last NPPES UpdateAugust 25, 2015

✔ NPI 1942442967 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in OH · 35.095291

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedHospitalistTaxonomy 208M00000X · License 35.095291 (OH)

30680 BAINBRIDGE RD, Cleveland, OH 44139

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource, Paramount.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 Kaplan Md 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 ID3971634437

PECOS Enrollment IDI20100626000488

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 Kaplan reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

University Hospitals Medical Group Inc

11 mi

Multi-Specialty

11100 EUCLID AVE
Cleveland, OH 44106

Reassigned Medicare billing, Ohio enrollment
3,958 clinicians in this Medicare group

NPI 1669499414 (216) 844-1000

Hni Medical Services Of Ohio, LLC

19 mi

Internal Medicine

18697 BAGLEY RD
Middleburg Heights, OH 44130

Reassigned Medicare billing, Ohio enrollment
144 clinicians in this Medicare group

NPI 1356815922 (440) 542-5000

North East Ohio Group Practice LLC

19 mi

Internal Medicine

18697 BAGLEY RD
Middleburg Heights, OH 44130

Reassigned Medicare billing, Ohio enrollment
238 clinicians in this Medicare group

NPI 1063575462 (440) 542-5000

Community Hospitalist, LLC

40 mi

Hospitalist

3700 KOLBE RD
Lorain, OH 44053

Reassigned Medicare billing, Ohio enrollment
325 clinicians in this Medicare group

NPI 1538236872 (440) 960-4000

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 7

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

810 services206 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

259 services228 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

129 services85 patients

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

115 services26 patients

Hospital discharge day management, more than 30 minutes 99239

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

99 services87 patients

Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more 99306

An initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.

25 services24 patients

Hospital Affiliations CMS Care Compare 2

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

Mercy Regional Medical Center

Acute Care Hospitals · Lorain, OH

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number360172

Location3700 Kolbe RoadLorain, OH 44053 · Lorain County

Emergency services Birthing friendly

Mercy Allen Hospital

Critical Access Hospitals · Oberlin, OH

OwnershipVoluntary non-profit - Private

CMS Certification Number361306

Location200 West Lorain StreetOberlin, OH 44074 · Lorain County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 44139 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

$126.12 typical visit price

range $54.34 – $166.65

Typical copayment $31.53 (range $13.58 – $41.66)

Most-billed visit code 99204

Established Patient

$96.44 typical visit price

range $17.10 – $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.

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.

75/100

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

Scored as part of a group practice

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

2 suppliers51 claims51 services$75.20 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

2 suppliers40 claims40 services$32.60 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 16

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

DEBRA S GUERINI M.D.

Internal Medicine

30680 BAINBRIDGE RD, COMMUNITY HOSPITALISTS
CLEVELAND, OH 44139

Cuyahoga County (440) 542-5023

DR. LAUREN MARIE SPALDING WALTER D.O.

Internal Medicine

30680 BAINBRIDGE RD
SOLON, OH 44139

Cuyahoga County (440) 542-5025

COMMUNITY HOSPITALISTS OF PENNSYLVANIA, INC

Internal Medicine

30680 BAINBRIDGE RD
SOLON, OH 44139

Cuyahoga County (440) 542-5023

FAMILY CARE CENTERS OF OHIO

Family Medicine

30680 BAINBRIDGE RD
SOLON, OH 44139

Cuyahoga County (440) 542-5000

DR. APARNA REDDY M.D.

Internal Medicine

30680 BAINBRIDGE RD, COMMUNITY HOSPITALISTS LLC
CLEVELAND, OH 44139

Cuyahoga County (440) 542-5000

DR. BILAL MOUSA ATAYA M.D.

Hospitalist

30680 BAINBRIDGE RD
CLEVELAND, OH 44139

Cuyahoga County (440) 542-5000

MRS. LISA ANN LORENZ APRN-BC

Nurse Practitioner (Acute Care)

30680 BAINBRIDGE RD
CLEVELAND, OH 44139

Cuyahoga County (440) 542-5000

PAT SERVICES, LLC

Internal Medicine

30680 BAINBRIDGE RD
SOLON, OH 44139

Cuyahoga County (440) 542-5023

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 Kaplan's NPI number?

The NPI number for Mark Kaplan is 1942442967. It was assigned to this individual provider in the NPPES registry on April 6, 2009.

Where is Mark Kaplan located?

Mark Kaplan practices at 30680 Bainbridge Rd, Cleveland, OH 44139. The listed phone number is (440) 542-5025.

What is Mark Kaplan's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Mark Kaplan enrolled in Medicare?

Yes. Mark Kaplan 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 Kaplan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mark Kaplan reassigns Medicare benefits to 4 organizations: University Hospitals Medical Group Inc (Cleveland, OH), Hni Medical Services Of Ohio, LLC (Middleburg Heights, OH), North East Ohio Group Practice LLC (Middleburg Heights, OH) and Community Hospitalist, LLC (Lorain, OH). 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 Kaplan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Mark Kaplan accept?

Health plans from Anthem Blue Cross and Blue Shield, CareSource and Paramount list Mark Kaplan 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 Kaplan affiliated with any hospitals?

According to CMS data, Mark Kaplan is affiliated with Mercy Regional Medical Center and Mercy Allen Hospital.

When was this NPI record last updated?

The NPPES record for Mark Kaplan was last updated on August 25, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.