MARSHALL LEWIS COOK MD
NPI 1205813318
Orthopaedic Surgery in Fort Defiance, AZ
NPI Status: Active since December 29, 2005
Contact Information
CORNER OF ROUTE N12 AND N7
FORT DEFIANCE, AZ
ZIP 86504
Phone: (928) 729-8000
- Individual
- Male
- Orthopaedic Surgery
- Accepts Insurance
- PECOS Enrolled
- Medicare Quality Reporting
About MARSHALL COOK
This page provides the complete NPI Profile along with additional information for Marshall Cook, a provider established in Fort Defiance, Arizona with a medical specialization in Orthopaedic Surgery. The healthcare provider is registered in the NPI registry with number 1205813318 assigned on December 2005. The practitioner's primary taxonomy code is 207X00000X with license number 19360 (AZ). The provider is registered as an individual and his NPI record was last updated 3 years ago.
- NPI
- 1205813318
- Provider Name
- MARSHALL LEWIS COOK MD
- Other Name
- MARK LEWIS COOK MD
- Other Name Type
- Other Name (5)
- Gender
- Male
- Entity Type
- Individual
- Location Address
- CORNER OF ROUTE N12 AND N7 FORT DEFIANCE, AZ 86504
- Location Phone
- (928) 729-8000
- Mailing Address
- PO BOX 649 FORT DEFIANCE, AZ 86504
- Mailing Phone
- (928) 729-8000
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 12-29-2005
- Last Update Date
- 03-17-2022
- Code Navigator
Location Map
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
Orthopaedic Surgery
- Taxonomy Code
- 207X00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 19360
- License State
- AZ
- Taxonomy Description
- An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207XX0005X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | AZ19360 (AZ) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue AdvanceHealth Bronze - Neighborhood Network - HMO
- Blue AdvanceHealth Gold - Neighborhood Network - HMO
- Blue AdvanceHealth Silver - Neighborhood Network - HMO
- Blue EverydayHealth Gold - Neighborhood Network - HMO
- Blue EverydayHealth Silver - Neighborhood Network - HMO
- Blue Portfolio HSA Bronze - Neighborhood Network - HMO
- Blue Portfolio HSA Gold - Statewide PPO Network - PPO
- Blue PPO PremierHealth Silver - Statewide PPO Network - PPO
- Blue PPO PremierHealth Gold - Statewide PPO Network - PPO
- Blue PPO StandardHealth Gold - Statewide PPO Network - PPO
- Blue PPO StandardHealth Silver - Statewide PPO Network - PPO
- Blue StandardHealth Bronze - Neighborhood Network - HMO
- Blue StandardHealth Gold - Neighborhood Network - HMO
- Blue StandardHealth Silver - Neighborhood Network - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Marshall Cook 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
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
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.
Aspiration and/or injection of fluid from large joint
Established patient office or other outpatient visit, 10-19 minutes
Established patient office or other outpatient visit, 20-29 minutes
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
This service was performed 44 times for 32 patientsThis 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.
This service was performed 43 times for 35 patientsThis 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 48 times for 38 patientsPhysician Visit Costs
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 86504 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $85.89
- Minimum New Patient Price $55.44
- Maximum New Patient Price $168.6
- Average New Patient Copayment $21.47
- Minimum New Patient Copayment $13.86
- Maximum New Patient Copayment $42.15
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $69.24
- Minimum Established Patient Price $17.72
- Maximum Established Patient Price $137.41
- Average Established Patient Copayment $17.31
- Minimum Established Patient Copayment $4.43
- Maximum Established Patient Copayment $34.35
* 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.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Chronic Care and Preventative Care Management for Empaneled Patients | Yes | N/A |
| Proactively manage chronic and preventive care for empaneled patients that could include one or more of the following: • Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions; • Use condition-specific pathways for care of chronic conditions (e.g., hypertension, diabetes, depression, asthma and heart failure) with evidence-based protocols to guide treatment to target; such as a CDC-recognized diabetes prevention program; • Use pre-visit planning to optimize preventive care and team management of patients with chronic conditions; • Use panel support tools (registry functionality) to identify services due; • Use predictive analytical models to predict risk, onset and progression of chronic diseases; or • Use reminders and outreach (e.g., phone calls, emails, postcards, patient portals and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation. | ||
| Documentation of Current Medications in the Medical Record | 100% | 777 |
| 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. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration | ||
| Implementation of medication management practice improvements | Yes | N/A |
| Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews. | ||
| Measurement and Improvement at the Practice and Panel Level | Yes | N/A |
| Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level. | ||
| Medication Reconciliation | 100% | 247 |
| 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. | ||
| Patient-Specific Education | 39% | 364 |
| 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. | ||
| Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 28% | 298 |
| 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 twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2 | ||
| Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 58% | 171 |
| 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 | ||
| Provide Patient Access | 86% | 364 |
| 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 certain information. | ||
| Secure Messaging | 8% | 364 |
| 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 message sent by the patient (or the patient-authorized representative) during the performance period. | ||
| Security Risk Analysis | Yes | N/A |
| Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. | ||
| Specialized Registry Reporting | Yes | N/A |
| The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI. | ||
| Use of decision support and standardized treatment protocols | Yes | N/A |
| Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs. | ||
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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. | |||||||||
| 1 | 2 | 0 | 5 | 8 | 1 | 3 | 3 | 1 | 8 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 0 | 5 | 16 | 1 | 6 | 3 | 2 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 2 + 0 + 5 + 1 + 6 + 1 + 6 + 3 + 2 + 24 = 52 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 52 = 8 | 8 | ||||||||
The NPI number 1205813318 is valid because the calculated check digit 8 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 |
|---|---|---|---|
| 1194795211 | MS. MARILYN DOOLINE-BEGAY LMSW Individual | Social Worker | CORNER OF ROUTE N12 AND N7 FORT DEFIANCE, AZ 86504 (928) 729-8532 |
| 1356457253 | MS. MARY L BEGAY LCSW Individual | Social Worker | CORNER OF ROUTE N12 AND N7 FORT DEFIANCE, AZ 86504 (928) 729-8527 |
| 1376627679 | JOHN VICTOR SIMPSON M.D. Individual | Otolaryngology | CORNER OF ROUTE N12 AND N7 FORT DEFIANCE, AZ 86504 (928) 729-8000 |
| 1750466249 | MR. MIKE DANNY FAZ PHYSICAL THERAPIST Individual | Physical Therapist | CORNER OF ROUTE N12 AND N7 FORT DEFIANCE PHS HOSPITAL FORT DEFIANCE, AZ 86504 (928) 729-8805 |
| 1871663617 | CRAIG W MEYER DPM Individual | Podiatrist | CORNER OF ROUTE N12 AND N7 FORT DEFIANCE PHS HOSPITAL FORT DEFIANCE, AZ 86504 (928) 729-8819 |
| 1124195060 | WALTER DROGOSZ CRNA Individual | Anesthesiology | CORNER OF ROUTE N12 AND N7 FT DEFIANCE PHS HOSPITAL FT DEFIANCE, AZ 86504 (928) 729-8749 |
| 1386703684 | MS. ANNE MADSEN C.N.M. Individual | Advanced Practice Midwife | CORNER OF ROUTE N12 AND N7 FORT DEFIANCE, AZ 86504 (928) 729-8797 |
| 1992869093 | JAMES EDWARD ZELICHOWSKI DPM Individual | Podiatrist | CORNER OF ROUTE N12 AND N7 FORT DEFIANCE, AZ 86504 (928) 729-8000 |
| 1417008541 | TERESA WILLIE CNM Individual | Advanced Practice Midwife | CORNER OF ROUTE N12 AND N7 FORT DEFIANCE, AZ 86504 (928) 729-8000 |
| 1720121734 | DAVID ALLEN FLEMING DDS Individual | Dentist (General Practice) | CORNER OF ROUTE N12 AND N7 FORT DEFIANCE, AZ 86504 (928) 729-8000 |
| 1255461174 | DR. LUISA RAHELL ALVAREZ O.D. Individual | Optometrist | CORNER OF ROUTE N12 AND N7 FORT DEFIANCE HOSPITAL BOARD, INC. FORT DEFIANCE, AZ 86504 (951) 312-9596 |
| 1770702383 | DR. ROBERT CALVIN LLOYD JR. DMD Individual | Dentist | CORNER OF ROUTE N12 AND N7 FORT DEFIANCE INDIAN HOSPITAL BOARD, INC. FORT DEFIANCE, AZ 86504 (928) 729-8898 |
| 1063675312 | DR. LYDIA PURVIS WINTERS DMD Individual | Dentist | CORNER OF ROUTE N12 AND N7 FORT DEFIANCE PHS HOSPITAL FORT DEFIANCE, AZ 86504 (928) 729-8000 |
| 1306176318 | MS. LUCINDA M WASETA LMSW Individual | Social Worker | CORNER OF ROUTE N12 AND N7 FORT DEFIANCE, AZ 86504 (928) 729-8531 |
| 1609171537 | MRS. ROBERTA MARIE DUNCAN R.D. Individual | Dietitian, Registered | CORNER OF ROUTE N12 AND N7 FORT DEFIANCE, AZ 86504 (928) 729-8424 |
| 1336435718 | MR. GARY S DAVIS Individual | Art Therapist | CORNER OF ROUTE N12 AND N7 FORT DEFIANCE, AZ 86504 (928) 729-3741 |
| 1215223458 | MR. JESSE JOSEPH KAULAITY BSW Individual | Counselor (Addiction (Substance Use Disorder)) | CORNER OF ROUTE N12 AND N7 FORT DEFIANCE, AZ 86504 (928) 729-8508 |
| 1265729610 | MR. DAN SMITH III RRT Individual | Respiratory Therapist, Registered | CORNER OF ROUTE N12 AND N7 FORT DEFIANCE, AZ 86504 (928) 729-8000 |
| 1669769956 | MRS. KENDALL RAE JOHN Individual | Specialist | CORNER OF ROUTE N12 AND N7 FORT DEFIANCE, AZ 86504 (928) 729-3755 |
| 1386932101 | DANIEL MIRELES GUERRERO RTT Individual | Respiratory Therapist, Certified | CORNER OF ROUTE N12 AND N7 FORT DEFIANCE, AZ 86504 (928) 729-8829 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1205813318, enumerated in the NPI registry as an "individual" on December 29, 2005
The provider is located at Corner Of Route N12 And N7 Fort Defiance, Az 86504 and the phone number is (928) 729-8000
The provider's speciality is Orthopaedic Surgery with taxonomy code 207X00000X
The provider might be accepting Accepts: Blue Cross Blue Shield of Arizona. 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.
Medicare beneficiaries should expect a typical cost of $85.89 with an average copayment of $21.47 for new patient appointments. Established patients should expect a typical charge of $69.24 and an average copayment of 17.31. 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: Aspiration and/or injection of fluid from large joint, Established patient office or other outpatient visit, 10-19 minutes and Established patient office or other outpatient visit, 20-29 minutes.
This NPI record was last updated on December 29, 2005. 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].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.