MARK E SOUTHER MD
NPI 1104888692
Internal Medicine in Newport News, VA


Quality Rating: 90.88 out of 100 score

NPI Status: Active since April 03, 2006

Contact Information

12420 WARWICK BLVD
BLDG. 3 SUITE 4A
NEWPORT NEWS, VA
ZIP 23606
Phone: (757) 594-4431
Fax: (757) 594-2936

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  • Individual
  • Male
  • Years of Experience 36
  • Internal Medicine
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About MARK SOUTHER

This page provides the complete NPI Profile along with additional information for Mark Souther, an internist established in Newport News, Virginia with a medical specialization in Internal Medicine and more than 36 years of experience. He graduated from University Of Missouri, Columbia School Of Medicine in 1990. The healthcare provider is registered in the NPI registry with number 1104888692 assigned on April 2006. The practitioner's primary taxonomy code is 207R00000X with license number 0101049650 (VA). The provider is registered as an individual and his NPI record was last updated 14 years ago.

NPI
1104888692
Provider Name
MARK E SOUTHER MD
Gender
Male
Entity Type
Individual
Location Address
12420 WARWICK BLVD BLDG. 3 SUITE 4A NEWPORT NEWS, VA 23606
Location Phone
(757) 594-4431
Location Fax
(757) 594-2936
Mailing Address
856 J CLYDE MORRIS BLVD SUITE A NEWPORT NEWS, VA 23601
Mailing Phone
(757) 594-4006
Mailing Fax
(757) 594-2936
Medical School Name
UNIVERSITY OF MISSOURI, COLUMBIA SCHOOL OF MEDICINE
Graduation Year
1990
Is Sole Proprietor?
No
Enumeration Date
04-03-2006
Last Update Date
05-17-2011
Code Navigator

An internist like Mark Souther is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Internal Medicine

Taxonomy Code
207R00000X
Type
Allopathic & Osteopathic Physicians
License No.
0101049650
License State
VA
Taxonomy Description
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.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
015473R53MEDICARE PIN (08)VA 
1104888692MEDICAID (05)VA 
F56842MEDICARE UPIN (02) 
110112335MEDICARE PIN (08)VA 

Medicare Participation & PECOS Enrollment Status

Mark Souther is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Mark Souther is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 1850382656

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20040520000793

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

  • DME-Other DME (DE017N)

    Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)

    18 DME suppliers used 63 Medicare Claims 180 Services Paid

  • DME-Medical/Surgical Supplies (DA000N)

    Lancets, per box of 100 (HCPCS:A4259)

    12 DME suppliers used 24 Medicare Claims 25 Services Paid

  • DME-Other DME (DE017N)

    Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service (HCPCS:K0553)

    4 DME suppliers used 32 Medicare Claims 32 Services Paid

Orthotic Devices

  • DME-Orthotic Devices (DF010N)

    Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each (HCPCS:A4425)

    1 DME suppliers used 11 Medicare Claims 40 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Adm sarscv2 30mcg trs-sucr b

This service involves the administration of a 30mcg dose of the SARS-CoV-2 vaccine, which helps protect against COVID-19. The 'trs-sucr b' indicates it's stabilized with sugars for effectiveness. It's a crucial step in maintaining your health during the pandemic.

This service was performed 45 times for 45 patients

Administration of influenza virus vaccine

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

This service was performed 269 times for 261 patients

Administration of pneumococcal vaccine

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

This service was performed 25 times for 25 patients

Administration of vaccine

Administering a vaccine involves injecting a small, safe piece of a virus or bacteria into your body. This triggers your immune system to recognize and fight off the disease in the future. It's a vital tool in preventing serious illnesses and maintaining public health.

This service was performed 29 times for 29 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

This service was performed 376 times for 376 patients

Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit

An annual wellness visit is a yearly appointment with your doctor to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's an opportunity to discuss your health status and goals and get a plan tailored for you.

This service was performed 36 times for 36 patients

Automated urinalysis test

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

This service was performed 85 times for 76 patients

Bacterial colony count, urine

A bacterial colony count, urine, is a laboratory test that checks a urine sample for bacteria. It helps to identify if an infection is present in the urinary system. High numbers of bacteria in the urine can indicate a urinary tract infection (UTI).

This service was performed 93 times for 65 patients

Bacterial culture for aerobic isolates

A bacterial culture for aerobic isolates is a lab test that helps identify bacteria that thrive in oxygen-rich environments. A sample from the suspected infection site is collected, then placed in a special medium that promotes bacterial growth. After a set period, the lab identifies any bacteria present, aiding in accurate diagnosis and treatment.

This service was performed 53 times for 37 patients

Blood test, basic group of blood chemicals (calcium, total)

A basic group blood test measures the levels of certain chemicals in your blood, including calcium. This helps assess your overall health and detect potential problems. The procedure involves drawing a small amount of blood from your arm, which is then analyzed in a lab.

This service was performed 65 times for 58 patients

Blood test, clotting time

A clotting time blood test helps determine how quickly your blood forms clots, a process crucial to stop bleeding. During the test, a small blood sample is taken from your arm. The sample is then analyzed in a lab to see how long it takes for a clot to form.

This service was performed 53 times for 12 patients

Blood test, comprehensive group of blood chemicals

A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.

This service was performed 1,056 times for 521 patients

Blood test, lipids (cholesterol and triglycerides)

A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.

This service was performed 715 times for 479 patients

Blood test, thyroid stimulating hormone (tsh)

A TSH blood test measures the level of thyroid stimulating hormone in your body. This hormone is produced by the pituitary gland and regulates how your thyroid works. It's a simple procedure where a small amount of blood is drawn from your arm for analysis.

This service was performed 914 times for 503 patients

Coagulation function measurement, d-dimer; quantitative

A quantitative D-dimer test measures the amount of D-dimer, a protein fragment, in your blood. This test helps detect abnormal blood clotting. D-dimer levels can rise in conditions where clots are forming and breaking down, such as deep vein thrombosis or pulmonary embolism.

This service was performed 28 times for 26 patients

Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous

A fecal occult blood test is a screening tool for colorectal cancer. It checks for tiny amounts of blood in your stool that can't be seen with the naked eye. The immunoassay method can test 1-3 samples at once. This helps detect cancer early, when treatment is most effective.

This service was performed 117 times for 117 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test

A complete blood cell count (CBC) is an automated test that measures different components of the blood, including red cells, white cells, and platelets. It helps assess overall health, detect disorders like anemia or infection, and monitor medical treatments.

This service was performed 11 times for 11 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count

A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.

This service was performed 1,084 times for 522 patients

Creatinine level to test for kidney function or muscle injury

A creatinine level test measures the amount of creatinine in your blood. This substance is a waste product from normal muscle use. Higher levels can indicate possible kidney dysfunction or muscle injury. This test helps monitor kidney health.

This service was performed 39 times for 37 patients

Cyanocobalamin (vitamin b-12) level

A Cyanocobalamin (Vitamin B-12) level test is a blood test that checks the amount of Vitamin B-12 in your body. This vitamin is vital for nerve function and the creation of red blood cells. Low or high levels could indicate a potential health issue.

This service was performed 115 times for 95 patients

Detection test by immunoassay with direct visual observation for influenza virus

This is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.

This service was performed 60 times for 29 patients

Established patient office or other outpatient visit, 20-29 minutes

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.

This service was performed 377 times for 247 patients

Established patient office or other outpatient visit, 30-39 minutes

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.

This service was performed 1,619 times for 574 patients

Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), microdilution or agar dilution

This process checks how well certain drugs, like antibiotics, can fight against infections. It involves mixing the drug with a microbe (like bacteria or a virus) in a lab. By observing how the microbe reacts, it helps determine the best drug to treat your infection.

This service was performed 52 times for 36 patients

Fee covid-19 vac 13 res

The "Fee Covid-19 Vac 13 Res" service refers to a charge for the 13th dose of the Covid-19 vaccine, typically for individuals requiring additional doses due to specific health conditions. It's crucial to follow your healthcare provider's advice for your health safety.

This service was performed 43 times for 43 patients

Ferritin (blood protein) level

A Ferritin level test measures the amount of ferritin, a protein that stores iron, in your blood. It helps determine how much iron your body is storing. If levels are low, it may indicate iron deficiency, while high levels could signify conditions like iron overload.

This service was performed 135 times for 101 patients

Hemoglobin a1c level

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

This service was performed 571 times for 276 patients

Hepatitis c antibody screening, for individual at high risk and other covered indication(s)

Hepatitis C antibody screening is a blood test performed to identify if you've been exposed to the Hepatitis C virus. This is especially important for individuals at high risk, such as those with certain health conditions or lifestyle factors. Early detection can lead to more effective treatments.

This service was performed 14 times for 14 patients

Influenza vaccine split virus, preservative free

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

This service was performed 266 times for 258 patients

Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment

An Initial Preventive Physical Examination, also known as a "Welcome to Medicare" visit, is a one-time, face-to-face visit during your first 12 months of Medicare enrollment. It includes a review of your health, as well as education and counseling about preventive services and further screenings.

This service was performed 14 times for 14 patients

Insertion of needle into vein for collection of blood sample

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

This service was performed 1,319 times for 553 patients

Iron binding capacity

Iron binding capacity is a blood test that measures how well your body can bind and transport iron. This helps your healthcare provider assess if your body has too little or too much iron, which can indicate certain health conditions.

This service was performed 129 times for 98 patients

Iron level

An iron level test measures the amount of iron in your blood. Iron is crucial for producing hemoglobin, a protein in red blood cells that carries oxygen throughout your body. This test helps identify iron deficiencies or excesses, which can lead to conditions like anemia or hemochromatosis.

This service was performed 130 times for 99 patients

Lipase (fat enzyme) level

A Lipase Level test measures the amount of lipase in your blood. Lipase is an enzyme that helps your body digest fats. High or low levels can indicate problems with your pancreas, such as pancreatitis or other conditions. This test helps your doctor diagnose and monitor these conditions.

This service was performed 19 times for 17 patients

Magnesium level

A magnesium level test is a simple blood test that measures the amount of magnesium in your body. Magnesium is a crucial mineral that helps your nerves, muscles, and heart function properly. The test can help detect health conditions like kidney disease or malnutrition.

This service was performed 90 times for 70 patients

Manual urinalysis test with examination using microscope, automated

A manual urinalysis test with automated microscopic examination is a lab process that checks your urine for health indicators. It involves a machine scanning your sample to identify any abnormal elements, which can assist in diagnosing various conditions.

This service was performed 330 times for 288 patients

Measurement c-reactive protein for detection of infection or inflammation

C-reactive protein (CRP) test is a blood test that checks for signs of inflammation or infection in the body. High levels of CRP often suggest that there's inflammation or a bacterial infection. This test helps in monitoring and managing conditions like arthritis and heart disease.

This service was performed 12 times for 12 patients

Natriuretic peptide (heart and blood vessel protein) level

A natriuretic peptide level test is a blood test that helps doctors check for heart failure. It measures the amount of certain proteins that your heart and blood vessels produce when they are under stress. High levels may indicate heart disease.

This service was performed 16 times for 13 patients

New patient office or other outpatient visit, 45-59 minutes

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.

This service was performed 20 times for 20 patients

Pneumococcal vaccine, 23-valent

The 23-valent pneumococcal vaccine is an injection that helps protect against serious infections caused by 23 types of pneumococcal bacteria. It's vital for those at risk, like older adults or people with certain health conditions, to prevent pneumonia, meningitis, and bloodstream infections.

This service was performed 19 times for 19 patients

Prostate cancer screening; prostate specific antigen test (psa)

Prostate cancer screening involves a simple blood test known as the Prostate Specific Antigen (PSA) test. This test measures the level of PSA in your blood. Higher than normal levels can be an early indication of prostate issues, including cancer. It's a key tool in early detection.

This service was performed 91 times for 91 patients

Protein measurement, serum

A serum protein measurement is a blood test that determines the levels of proteins in your blood. It is used to evaluate your overall health, and diagnose nutritional problems, kidney disease, liver disease, or immune disorders.

This service was performed 35 times for 34 patients

Psa (prostate specific antigen) measurement, complexed

A PSA measurement is a blood test that helps check the health of a certain gland in your body. The 'complexed' part means it specifically looks for a certain type of protein. This test is often used to detect potential issues early and to monitor ongoing conditions.

This service was performed 14 times for 14 patients

Psa (prostate specific antigen) measurement, total

PSA measurement is a simple blood test that checks for a specific protein produced by your body. High levels could indicate a health issue that needs further investigation. It's often used to monitor general wellness and is part of routine health screening.

This service was performed 15 times for 15 patients

Red blood cell sedimentation rate, to detect inflammation, automated

The Red Blood Cell Sedimentation Rate is a test that helps detect inflammation in the body. It's automated, meaning a machine does the work. This test measures how fast red blood cells settle at the bottom of a tube in an hour. A faster rate may indicate inflammation.

This service was performed 21 times for 21 patients

Red blood count, automated test

An automated red blood count test is a routine lab procedure to measure the number of red blood cells in your blood. These cells carry oxygen throughout the body. The test helps assess overall health and detect conditions like anemia or polycythemia.

This service was performed 43 times for 35 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

This service was performed 78 times for 70 patients

Stool analysis for blood to screen for colon tumors

A stool analysis for blood is a non-invasive procedure used to check for the presence of hidden blood in your stool. This can be an early sign of colon tumors. The test involves collecting a small sample of stool at home and sending it to a lab for analysis.

This service was performed 33 times for 33 patients

Stool analysis for blood, by peroxidase activity

A stool analysis for blood, by peroxidase activity, is a test to detect blood in your stool. This test helps identify bleeding in the digestive tract. It involves collecting a stool sample, which is then checked for the presence of blood using a chemical reaction.

This service was performed 20 times for 20 patients

Thyroid hormone, t3 measurement, free

The T3 measurement, free, is a blood test that checks the level of a hormone called triiodothyronine. This hormone is produced by your thyroid, a small gland in your neck. It plays a key role in regulating your body's metabolism and energy use.

This service was performed 18 times for 14 patients

Thyroxine (thyroid chemical), free

The Thyroxine (thyroid chemical), free test is a blood test that measures the level of free T4 in your body. T4 is a hormone produced by your thyroid gland and is essential for growth and metabolism. If your T4 levels are too high or too low, it could indicate a thyroid disorder.

This service was performed 216 times for 162 patients

Transitional care management services for problem of moderate complexity

Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.

This service was performed 24 times for 23 patients

Uric acid level, blood

A blood uric acid level test measures the amount of uric acid in your blood. Uric acid is a waste product that your body produces when it breaks down purines, substances found in your body and in certain foods. High levels may lead to gout or kidney stones.

This service was performed 24 times for 20 patients

Urinalysis, manual test

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

This service was performed 24 times for 21 patients

Urine microalbumin (protein) level

The urine microalbumin level test measures the amount of a protein called albumin in your urine. This test helps to detect early signs of kidney damage. High levels of albumin may suggest your kidneys aren't functioning properly. It's a simple, non-invasive test that involves providing a urine sample.

This service was performed 39 times for 37 patients

Vitamin d-3 level

A Vitamin D-3 level test measures the amount of Vitamin D-3, a crucial nutrient, in your body. This test helps identify if your levels are too low or too high. Low levels may lead to bone weakness, while high levels could harm your kidneys. It's a simple blood test.

This service was performed 354 times for 309 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $32.26 for a new patient copayment and $24.78 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 23606 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $129.04
  • Minimum New Patient Price $56.19
  • Maximum New Patient Price $170.3
  • Average New Patient Copayment $32.26
  • Minimum New Patient Copayment $14.04
  • Maximum New Patient Copayment $42.57

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $99.13
  • Minimum Established Patient Price $18.07
  • Maximum Established Patient Price $138.91
  • Average Established Patient Copayment $24.78
  • Minimum Established Patient Copayment $4.51
  • Maximum Established Patient Copayment $34.72

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 90.88, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

  • Final Score: 90.88 out of 100

    The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

  • Quality Score: 86.86

    The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

    There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.

  • Promoting Interoperability Score: 86.88

    The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

    The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

  • Improvement Activities Score: 40

    The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.

    The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Mark Souther is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
RIVERSIDE REGIONAL MEDICAL CENTER500 J CLYDE MORRIS BLVD
NEWPORT NEWS, VA 23601
(757) 594-2000Acute Care Hospitals
SENTARA CAREPLEX HOSPITAL3000 COLISEUM DRIVE
HAMPTON, VA 23666
(757) 736-1000Acute Care Hospitals
RIVERSIDE WALTER REED HOSPITAL7519 HOSPITAL ROAD
GLOUCESTER, VA 23061
(804) 693-8800Acute Care Hospitals
RIVERSIDE DOCTORS' HOSPITAL OF WILLIAMSBURG1500 COMMONWEALTH AVENUE
WILLIAMSBURG, VA 23185
(757) 585-2010Acute Care Hospitals

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1104888692
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
210416816618
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 1 + 0 + 4 + 1 + 6 + 8 + 1 + 6 + 6 + 1 + 8 + 24 = 68
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 68 = 22

The NPI number 1104888692 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1316911290 STEVEN G SPELLMAN MD
Individual
Ophthalmology12420 WARWICK BLVD BLDG. 1, SUITE D
NEWPORT NEWS, VA 23606
(757) 599-0700
1750356960 JAMES C SPILLER DO
Individual
Internal Medicine12420 WARWICK BLVD BLDG 3 SUITE 4A
NEWPORT NEWS, VA 23606
(757) 594-4431
1992759799MR. CHRISTIAN W MOSEMANN
Individual
Social Worker (Clinical)12420 WARWICK BLVD BUILDING 7, SUITE C
NEWPORT NEWS, VA 23606
(757) 595-3900
1417993270MS. ALISON OHSOL ALLEN LCSW
Individual
Social Worker (Clinical)12420 WARWICK BLVD BLDG.7 SUITE C
NEWPORT NEWS, VA 23606
(757) 595-3900
1013940279MRS. LEE KELLY BOWDITCH L.P.C.
Individual
Counselor (Mental Health)12420 WARWICK BLVD BLDG. 7 SUITE C
NEWPORT NEWS, VA 23606
(757) 595-3900
1366477796DR. DORSEY THOMAS WESSELLS JR. ED.D.
Individual
Marriage & Family Therapist12420 WARWICK BLVD SUITE 7-C
NEWPORT NEWS, VA 23606
(757) 595-3900
1811914872JAMES RIVER FAMILY PRACTICE, LLC
Organization
Family Medicine12420 WARWICK BLVD 7B
NEWPORT NEWS, VA 23606
(757) 599-5588
1780608133RIVERSIDE PHYSICIAN SERVICES INC
Organization
Internal Medicine12420 WARWICK BLVD BLDG. 3-SUITE 4A
NEWPORT NEWS, VA 23606
(757) 594-4431
1275544496MS. NANCY J HECKER LPC
Individual
Counselor (Professional)12420 WARWICK BLVD BLDG 7 SUITE C
NEWPORT NEWS, VA 23606
(757) 595-3900
1235253246 ILENE FORREST STEPHAN M.D.
Individual
Internal Medicine12420 WARWICK BLVD BUILDING 3, SUITE 4A
NEWPORT NEWS, VA 23606
(757) 594-4431
1942467394DR. MELISSA ANNA RESTREPO D.M.D
Individual
Dentist (General Practice)12420 WARWICK BLVD SUITE 1A
NEWPORT NEWS, VA 23606
(757) 595-6224
1285894568MS. PATRICIA ELAINE ROBINSON RNC WHNP CCD
Individual
Nurse Practitioner (Women's Health)12420 WARWICK BLVD SUITE 5B
NEWPORT NEWS, VA 23606
(757) 596-6369
1548424872DR. ANDRIA CHAPMAN DDS
Individual
Dentist12420 WARWICK BLVD SUITE1A
NEWPORT NEWS, VA 23606
(757) 595-6224
1194972497WARWICK DENTAL CENTER, PLLC
Organization
Dentist (General Practice)12420 WARWICK BLVD 1A
NEWPORT NEWS, VA 23606
(757) 595-6224
1629220819COMPLETE HEALTHCARE, LLC
Organization
Family Medicine12420 WARWICK BLVD SUITE 5B
NEWPORT NEWS, VA 23606
(757) 596-6369
1841443256RIVERSIDE PHYSICIAN SERVICES INC
Organization
Physical Medicine & Rehabilitation (Pain Medicine)12420 WARWICK BLVD BLDG. 3 SUITE C
NEWPORT NEWS, VA 23606
(757) 534-5500
1528293644MRS. PHYLLIS ELAINE THOMAS WHNPC
Individual
Registered Nurse (Women's Health Care, Ambulatory)12420 WARWICK BLVD BUILDING 5
NEWPORT NEWS, VA 23606
(757) 596-6369
1326323254JEFFREY N KENNEY DDS PLLC
Organization
Dentist (Oral and Maxillofacial Surgery)12420 WARWICK BLVD SUITE 2A
NEWPORT NEWS, VA 23606
(757) 595-1457
1750715389 RUPINDER KAUR UPPAL DDS
Individual
Dentist12420 WARWICK BLVD 1A
NEWPORT NEWS, VA 23606
(757) 595-6224
1780646273 DENISE YVETTE DUHON MD
Individual
Internal Medicine12420 WARWICK BLVD BLDG. 3
NEWPORT NEWS, VA 23606
(757) 594-4431

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1104888692, enumerated in the NPI registry as an "individual" on April 03, 2006

The provider is located at 12420 Warwick Blvd Bldg. 3 Suite 4a Newport News, Va 23606 and the phone number is (757) 594-4431

The provider's speciality is Internal Medicine with taxonomy code 207R00000X

The provider has more than 36 years of experience. He graduated from University Of Missouri, Columbia School Of Medicine in 1990.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

The provider has an overall high rating in the following quality measures: quality clinical practices and patient outcomes and experiences , uses technology to exchange and make use of healthcare information.

Medicare beneficiaries should expect a typical cost of $129.04 with an average copayment of $32.26 for new patient appointments. Established patients should expect a typical charge of $99.13 and an average copayment of 24.78. Please review your insurance plan or contact the provider directly to determine your specific costs.

The most common procedures or services performed by this practitioner are: Adm sarscv2 30mcg trs-sucr b, Administration of influenza virus vaccine, Administration of pneumococcal vaccine, Administration of vaccine, Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit, Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit, Automated urinalysis test, Bacterial colony count, urine, Bacterial culture for aerobic isolates, Blood test, basic group of blood chemicals (calcium, total), Blood test, clotting time, Blood test, comprehensive group of blood chemicals, Blood test, lipids (cholesterol and triglycerides), Blood test, thyroid stimulating hormone (tsh), Coagulation function measurement, d-dimer; quantitative, Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous, Complete blood cell count (red cells, white blood cell, platelets), automated test, Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count, Creatinine level to test for kidney function or muscle injury, Cyanocobalamin (vitamin b-12) level, Detection test by immunoassay with direct visual observation for influenza virus, Established patient office or other outpatient visit, 20-29 minutes, Established patient office or other outpatient visit, 30-39 minutes, Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), microdilution or agar dilution, Fee covid-19 vac 13 res, Ferritin (blood protein) level, Hemoglobin a1c level, Hepatitis c antibody screening, for individual at high risk and other covered indication(s), Influenza vaccine split virus, preservative free, Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment, Insertion of needle into vein for collection of blood sample, Iron binding capacity, Iron level, Lipase (fat enzyme) level, Magnesium level, Manual urinalysis test with examination using microscope, automated, Measurement c-reactive protein for detection of infection or inflammation, Natriuretic peptide (heart and blood vessel protein) level, New patient office or other outpatient visit, 45-59 minutes, Pneumococcal vaccine, 23-valent, Prostate cancer screening; prostate specific antigen test (psa), Protein measurement, serum, Psa (prostate specific antigen) measurement, complexed, Psa (prostate specific antigen) measurement, total, Red blood cell sedimentation rate, to detect inflammation, automated, Red blood count, automated test, Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report, Stool analysis for blood to screen for colon tumors, Stool analysis for blood, by peroxidase activity, Thyroid hormone, t3 measurement, free, Thyroxine (thyroid chemical), free, Transitional care management services for problem of moderate complexity, Uric acid level, blood, Urinalysis, manual test, Urine microalbumin (protein) level and Vitamin d-3 level.

The practitioner is affiliated to the following hospital(s): RIVERSIDE REGIONAL MEDICAL CENTER, SENTARA CAREPLEX HOSPITAL, RIVERSIDE WALTER REED HOSPITAL and RIVERSIDE DOCTORS' HOSPITAL OF WILLIAMSBURG. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on April 03, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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