Mark E Endicott Orthopedic Surgery
200 Mission Blvd, Jackson, CA 95642-2564


Mark E Endicott is physician registered in the Centers for Medicare & Medicaid Services (CMS). The National Provider Identifier (NPI) of the National Plan and Provider Enumeration System (NPPES) is 1093783425. The unique individual professional ID assigned by Provider Enrollment, Chain, and Ownership System (PECOS) is 8921165838. The primary specialty is ORTHOPEDIC SURGERY. The organization is SURGICAL AFFILIATES OF CALIFORNIA. The address is 200 Mission Blvd, Jackson, CA 95642-2564. The zip code is 95642.


Mark E Endicott · 200 Mission Blvd, Jackson, CA 95642-2564

Nation Provider ID 1093783425
PAC ID by PECOS 8921165838
Professional Enrollment ID I20090320000175
Last Name ENDICOTT
First Name MARK
Middle Name E
Gender M
Medical School Name GEORGE WASHINGTON UNIVERSITY SCHOOL OF MEDICINE
Graduation Year 1980
Primary Specialty ORTHOPEDIC SURGERY
Primary Specialty SURGICAL AFFILIATES OF CALIFORNIA
Group Practice PAC ID 3375782667
Number of Group Practice Members 16
Address 200 MISSION BLVD
JACKSON, CA 956422564
Claims Based Hospital Affiliation Claim Control Number (CCN): 050014
Legal Business Name: SUTTER AMADOR HOSPITAL
Claims Based Hospital Affiliation Claim Control Number (CCN): 050108
Legal Business Name: SUTTER MEDICAL CENTER, SACRAMENTO
Claims Based Hospital Affiliation Claim Control Number (CCN): 050017
Legal Business Name: MERCY GENERAL HOSPITAL
Claims Based Hospital Affiliation Claim Control Number (CCN): 051332
Legal Business Name: MARK TWAIN MEDICAL CENTER
Professional accepts Medicare Assignment Y
Report Quality Measures Y
Use Electronic Health Records Y

street_number: 200
route: Mission Boulevard (Mission Blvd)
locality, political: Jackson
admin_level_2, political: Amador County
admin_level_1, political: California (CA)
country, political: United States (US)
postal_code: 95642
postal_code_suffix: 2564
types : street_address
latitude: 38.3504826
longitude: -120.764465
latlng: (38.3504826, -120.764465)


Surgical Affiliates of California · Medicare Physician

Name Address Specialty
Amber Chatwin 5176 Hill Rd E, Lakeport, CA 95453-6300 ORTHOPEDIC SURGERY
Pamela Mehta 520 W I St, Los Banos, CA 93635-3419 ORTHOPEDIC SURGERY
Wei Loong Koh 200 Mission Blvd, Jackson, CA 95642-2564 GENERAL SURGERY
Rafael Montecino 200 Mission Blvd, Jackson, CA 95642-2564 GENERAL SURGERY
Kerisimasi Reynolds 5196 Hill Rd E, Lakeport, CA 95453-6362 ORTHOPEDIC SURGERY

Zip 95642 · Orthopedic Surgery · Medicare Physician

Name Address Specialty
Roger Rogalski 613 New York Ranch Rd, Jackson, CA 95642-9328 ORTHOPEDIC SURGERY
David Bethune 815 Court St, Jackson, CA 95642-2154 ORTHOPEDIC SURGERY
Charles Sonu 100 Mission Blvd, Jackson, CA 95642-2536 ORTHOPEDIC SURGERY
Thomas Mckenzie 815 Court St, Jackson, CA 95642-2154 ORTHOPEDIC SURGERY
Christopher Walthour 815 Court St, Jackson, CA 95642-2154 ORTHOPEDIC SURGERY
Paul Metzger 200 Mission Blvd, Jackson, CA 95642-2564 ORTHOPEDIC SURGERY
Victor Macko 815 Court St, Jackson, CA 95642-2154 ORTHOPEDIC SURGERY
Raymond Pierson 813 Court St, Jackson, CA 95642-2170 ORTHOPEDIC SURGERY
Michael Fry 613 New York Ranch Rd, Jackson, CA 95642-9328 ORTHOPEDIC SURGERY

Zip 95642 · Medicare Physician

Name Address Specialty
Kevin Rine 815 Court St, Jackson, CA 95642-2154 OBSTETRICS/GYNECOLOGY
Carlos Delgado 815 Court St, Jackson, CA 95642-2154 FAMILY PRACTICE
Gregory Vuksinich 200 Mission Blvd, Jackson, CA 95642-2564 ANESTHESIOLOGY
Shawn Brady 200 Mission Blvd, Jackson, CA 95642-2564 EMERGENCY MEDICINE
David Melniczek 200 Mission Blvd, Jackson, CA 95642-2564 GENERAL SURGERY
George Schilling 815 Court St, Jackson, CA 95642-2154 INTERNAL MEDICINE
Jonathan Schafer 815 Court St, Jackson, CA 95642-2154 FAMILY PRACTICE
Jane Maloney 815 Court St, Jackson, CA 95642-2154 OBSTETRICS/GYNECOLOGY
Manavjyot Heer 815 Court St, Jackson, CA 95642-2154 INTERNAL MEDICINE
Thomas Mckenzie 815 Court St, Jackson, CA 95642-2154 ORTHOPEDIC SURGERY
David Duncan 815 Court St, Jackson, CA 95642-2154 FAMILY PRACTICE
Marian Fitzpatrick 615 New York Ranch Rd, Jackson, CA 95642-9355 PHYSICAL THERAPY
Deon Tadlock 605 New York Ranch Rd, Jackson, CA 95642-9328 FAMILY PRACTICE
Bradford Chew 200 Mission Blvd, Jackson, CA 95642-2564 ANESTHESIOLOGY
William Fulton 100 Mission Blvd, Jackson, CA 95642-2536 GENERAL SURGERY
Geraldine Oshea 235 New York Ranch Rd B, Jackson, CA 95642-2147 INTERNAL MEDICINE
Elizabeth Ross 815 Court St, Jackson, CA 95642-2154 NURSE PRACTITIONER
Khin Ma 815 Court St, Jackson, CA 95642-2154 ENDOCRINOLOGY
Krystin Granger 200 Mission Blvd, Jackson, CA 95642-2564 ANESTHESIOLOGY
Janice Mcgeorge 817 Court St, Jackson, CA 95642-2156 OPTOMETRY