DR. MARK DAVID PINKERTON MD
NPI 1437138328
Family Medicine in Cedarville, OH
NPI Status: Active since January 10, 2006
Contact Information
251 N MAIN ST
CEDARVILLE, OH
ZIP 45314
Phone: (937) 766-7417
Fax: (937) 766-7865
- Individual
- Male
- Family Medicine
- Accepts Insurance
- PECOS Enrolled
About MARK PINKERTON
This page provides the complete NPI Profile along with additional information for Mark Pinkerton, a primary care provider established in Cedarville, Ohio with a medical specialization in Family Medicine. The healthcare provider is registered in the NPI registry with number 1437138328 assigned on January 2006. The practitioner's primary taxonomy code is 207Q00000X with license number 35063921 (OH). The provider is registered as an individual and his NPI record was last updated 9 years ago.
- NPI
- 1437138328
- Provider Name
- DR. MARK DAVID PINKERTON MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 251 N MAIN ST CEDARVILLE, OH 45314
- Location Phone
- (937) 766-7417
- Location Fax
- (937) 766-7865
- Mailing Address
- 251 N MAIN ST CEDARVILLE, OH 45314
- Mailing Phone
- (937) 766-7417
- Mailing Fax
- (937) 766-7865
- Is Sole Proprietor?
- No
- Enumeration Date
- 01-10-2006
- Last Update Date
- 12-05-2016
- Code Navigator
A primary care provider (PCP) like Mark Pinkerton sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
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
Family Medicine
- Taxonomy Code
- 207Q00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 35063921
- License State
- OH
- Taxonomy Description
- Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
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 | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | 33488 (CO) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Bronze First 7500 $25 Generic Drugs - HMO
- Bronze First 7500 $25 Generic Drugs Adult Vision & Fitness - HMO
- Core Gold 1500 $10 Generic Drugs - HMO
- Core Gold 1500 $10 Generic Drugs Adult Vision & Fitness - HMO
- Diabetes Gold 1100 $0 Select Drugs & Specialized Services - HMO
- Diabetes Gold 1100 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- Diabetes Silver 4000 $0 Select Drugs & Specialized Services - HMO
- Diabetes Silver 4000 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- Gold 1500 $15 Generic Drugs - HMO
- Gold 1500 $15 Generic Drugs Adult Vision & Fitness - HMO
- HDHP Preventive Silver 5500 $0 Select Drugs - HMO
- Healthy Heart Gold 1500 $0 Select Drugs & Specialized Services - HMO
- Healthy Heart Gold 1500 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- Healthy Heart Silver 4500 $0 Select Drugs & Specialized Services - HMO
- Healthy Heart Silver 4500 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- Low Premium Silver 6000 $3 Generic Drugs - HMO
- Low Premium Silver 6000 $3 Generic Drugs Adult Vision & Fitness - HMO
- Silver 5000 $20 Generic Drugs - HMO
- Silver 5000 $20 Generic Drugs Adult Vision & Fitness - HMO
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 |
---|---|---|---|
F83947 | MEDICARE UPIN (02) | ||
01334887 | MEDICAID (05) | CO | |
3144912 | MEDICAID (05) | OH | |
4320081 | MEDICARE PIN (08) | OH |
Medicare Participation & PECOS Enrollment Status
Mark Pinkerton 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.
Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus
Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19)
Established patient office or other outpatient visit, 30-39 minutes
New patient office or other outpatient visit, 45-59 minutes
An immunoassay test for severe acute respiratory syndrome coronavirus is a diagnostic tool. It uses your body's immune response to detect the presence of the virus. It involves taking a sample, usually from your nose or throat, which is then analyzed in a lab for signs of the virus.
This service was performed 15 times for 15 patientsThis is a test to detect COVID-19, the virus causing severe respiratory illness. It uses a method called immunoassay, which identifies the virus by its unique proteins. The test is directly observed for accuracy. It helps determine if you're currently infected.
This service was performed 26 times for 24 patientsThis 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 51 times for 45 patientsThis 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 46 times for 46 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 45314 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $84.72
- Minimum New Patient Price $54.34
- Maximum New Patient Price $166.65
- Average New Patient Copayment $21.18
- Minimum New Patient Copayment $13.58
- Maximum New Patient Copayment $41.66
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $96.44
- Minimum Established Patient Price $17.1
- Maximum Established Patient Price $135.4
- Average Established Patient Copayment $24.11
- Minimum Established Patient Copayment $4.27
- Maximum Established Patient Copayment $33.85
* 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.
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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 | 4 | 3 | 7 | 1 | 3 | 8 | 3 | 2 | 8 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 4 | 6 | 7 | 2 | 3 | 16 | 3 | 4 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 4 + 6 + 7 + 2 + 3 + 1 + 6 + 3 + 4 + 24 = 62 | |||||||||
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
70 - 62 = 8 | 8 |
The NPI number 1437138328 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 |
---|---|---|---|
1174680318 | CEDARVILLE UNIVERSITY Organization | Clinic/Center (Student Health) | 251 N MAIN ST CEDARVILLE, OH 45314 (937) 766-7862 |
1013046721 | MR. EVAN V. HELLWIG PHD, ATC, PT Individual | Physical Therapist | 251 N MAIN ST CEDARVILLE, OH 45314 (937) 766-7691 |
1598887994 | CHARLES D DOLPH PH.D. Individual | Psychologist | 251 N MAIN ST CEDARVILLE, OH 45314 (937) 766-7972 |
1356572499 | MRS. MELANIE J. ESTEPP RN Individual | Registered Nurse | 251 N MAIN ST 105 MCCHESNEY CEDARVILLE, OH 45314 (937) 766-2211 |
1962797555 | PROF. JEFFREY HUSTON R.PH. Individual | Pharmacist | 251 N MAIN ST CEDARVILLE, OH 45314 (937) 766-7486 |
1780965475 | MRS. CATHERINE MARY AVILES RN, BSN Individual | Registered Nurse (College Health) | 251 N MAIN ST CEDARVILLE, OH 45314 (937) 766-7862 |
1124309828 | MRS. BEVERLY JOAN ROBEY R.N. B.C. Individual | Registered Nurse (College Health) | 251 N MAIN ST CEDARVILLE, OH 45314 (937) 766-7862 |
1174804850 | MRS. DEBRA K MCDONALD RN, BSN, BC Individual | Registered Nurse (College Health) | 251 N MAIN ST CEDARVILLE, OH 45314 (937) 766-7862 |
1558642165 | MRS. LINDA FRANSON OVERTURF BSN,RN,BC Individual | Registered Nurse (College Health) | 251 N MAIN ST CEDARVILLE, OH 45314 (937) 766-7862 |
1740561364 | MRS. REBECCA JEAN KIRBY RN Individual | Registered Nurse (College Health) | 251 N MAIN ST CEDARVILLE, OH 45314 (937) 766-7862 |
1689910093 | CEDARVILLE UNIVERSITY EMS Organization | Ambulance | 251 N MAIN ST CEDARVILLE, OH 45314 (937) 766-7862 |
1083860878 | DR. TRACY FRAME PHARM.D. Individual | Pharmacist | 251 N MAIN ST CEDARVILLE, OH 45314 (937) 766-7426 |
1487078242 | KURT BEACHY MS, AT, ATC Individual | Specialist/Technologist (Athletic Trainer) | 251 N MAIN ST CEDARVILLE, OH 45314 (937) 766-4135 |
1710376298 | MRS. AMANDA R MEADE ATC Individual | Specialist/Technologist (Athletic Trainer) | 251 N MAIN ST CEDARVILLE, OH 45314 (937) 766-6156 |
1427447903 | WESLEY R STEPHENS AT Individual | Specialist/Technologist (Athletic Trainer) | 251 N MAIN ST CEDARVILLE, OH 45314 (937) 766-4493 |
1679963045 | HANNAH STEDGE MS, AT Individual | Specialist/Technologist (Athletic Trainer) | 251 N MAIN ST CEDARVILLE, OH 45314 (937) 766-3190 |
1851781504 | REBECCA STOKES Individual | Specialist/Technologist (Athletic Trainer) | 251 N MAIN ST CEDARVILLE, OH 45314 (937) 766-3063 |
1952792129 | MISS LAUREN CHRISTINE JACKSON Individual | Student in an Organized Health Care Education/Training Program | 251 N MAIN ST BOX 3754 CEDARVILLE, OH 45314 (937) 681-8389 |
1336692318 | DR. JUANITA ANN DRAIME PHARMD Individual | Pharmacist | 251 N MAIN ST CEDARVILLE, OH 45314 (937) 766-3171 |
1912380999 | KURT GRUENBERG MS, AT, ATC Individual | Specialist/Technologist (Athletic Trainer) | 251 N MAIN ST CEDARVILLE, OH 45314 (937) 766-7700 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1437138328, enumerated in the NPI registry as an "individual" on January 10, 2006
The provider is located at 251 N Main St Cedarville, Oh 45314 and the phone number is (937) 766-7417
The provider's speciality is Family Medicine with taxonomy code 207Q00000X
The provider might be accepting Accepts: CareSource, 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.
Medicare beneficiaries should expect a typical cost of $84.72 with an average copayment of $21.18 for new patient appointments. Established patients should expect a typical charge of $96.44 and an average copayment of 24.11. 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: Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus, Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19), Established patient office or other outpatient visit, 30-39 minutes and New patient office or other outpatient visit, 45-59 minutes.
This NPI record was last updated on January 10, 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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