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 ACUTE CARE SURGERY MEDICAL GROUP INC. 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 ACUTE CARE SURGERY MEDICAL GROUP INC
Group Practice PAC ID 7214006816
Number of Group Practice Members 64
Address 200 MISSION BLVD
JACKSON, CA 956422564
Claims Based Hospital Affiliation Claim Control Number (CCN): 050014
Legal Business Name: SUTTER HEALTH SACRAMENTO SIERRA REGION
Claims Based Hospital Affiliation Claim Control Number (CCN): 050108
Legal Business Name: SUTTER HEALTH SACRAMENTO SIERRA REGION
Claims Based Hospital Affiliation Claim Control Number (CCN): 050017
Legal Business Name: DIGNITY HEALTH
Claims Based Hospital Affiliation Claim Control Number (CCN): 050254
Legal Business Name: MARSHALL MEDICAL CENTER
Professional accepts Medicare Assignment Y
Participates in Medicare Electronic Health Record (EHR) Y
Participates in Medicare Physician Quality Reporting System (PQRS) Y

Acute Care Surgery Medical Group Inc · Medicare Physician

Name Address Specialty
Boris Borazjani 27700 Medical Ctr Rd, Mission Viejo, CA 92691 GENERAL SURGERY
Stephen Desantis 27700 Medical Ctr Rd, Mission Viejo, CA 92691 GENERAL SURGERY
Leslie Lyda 6501 Coyle Ave, Carmichael, CA 95608 NURSE PRACTITIONER
Matthew Kozloff 27700 Medical Ctr Rd, Mission Viejo, CA 92691 GENERAL SURGERY
Jill Alioto 6501 Coyle Ave, Carmichael, CA 95608 NURSE PRACTITIONER
Kevin Mitchell 6501 Coyle Ave, Carmichael, CA 95608 GENERAL SURGERY
Ann Vercoutere 520 W I St, Los Banos, CA 93635 GENERAL SURGERY
Amir Jamali 200 Mission Blvd, Jackson, CA 95642 ORTHOPEDIC SURGERY
Neil Grieshop 27700 Medical Ctr Rd, Mission Viejo, CA 92691 GENERAL SURGERY
Lindita Coku 70 Dubois St, Newburgh, NY 12550 CARDIAC SURGERY
David Beffa 6501 Coyle Ave, Carmichael, CA 95608 EMERGENCY MEDICINE
Samona Macdonald 520 W I St, Los Banos, CA 93635 NURSE PRACTITIONER
David Skeehan 6501 Coyle Ave, Carmichael, CA 95608 GENERAL SURGERY
Gloria Jimenez 1200 B Gale Wilson Blvd, Fairfield, CA 94533 GENERAL SURGERY
William Fulton 1000 Nut Tree Rd, Vacaville, CA 95687 GENERAL SURGERY
Mary Mockus 5176 Hill Rd E, Lakeport, CA 95453 GENERAL SURGERY
Andres Crowley 200 Mission Blvd, Jackson, CA 95642 GENERAL SURGERY
Erwin Douyon 70 Dubois St, Newburgh, NY 12550 GENERAL SURGERY
Amalya D'altorio 27700 Medical Ctr Rd, Mission Viejo, CA 92691 NURSE PRACTITIONER

Zip 95642 · Orthopedic Surgery · Medicare Physician

Name Address Specialty
Amir Jamali 200 Mission Blvd, Jackson, CA 95642 ORTHOPEDIC SURGERY
Paul Metzger 817s State Hwy 49, Jackson, CA 95642 ORTHOPEDIC SURGERY
Roger Rogalski 613 New York Ranch Rd, Jackson, CA 95642 ORTHOPEDIC SURGERY
Raymond Pierson 813 Court St, Jackson, CA 95642 ORTHOPEDIC SURGERY
Jeffrey Bergeson 815 Court St, Jackson, CA 95642 ORTHOPEDIC SURGERY

Zip 95642 · Medicare Physician

Name Address Specialty
Gary Shi 617 New York Ranch Rd, Jackson, CA 95642 HEMATOLOGY/ONCOLOGY
Shanti Siddiqui 609 New York Ranch Rd, Jackson, CA 95642 INTERNAL MEDICINE
Kevin Blasingame 665 New York Ranch Rd, Jackson, CA 95642 INTERNAL MEDICINE
Philip Granchi 200 Mission Blvd, Jackson, CA 95642 DIAGNOSTIC RADIOLOGY
Khristine Papa 200 Mission Blvd, Jackson, CA 95642 INTERNAL MEDICINE
Mohammed Siddiqui 200 Mission Blvd, Jackson, CA 95642 INTERNAL MEDICINE
Rashita Aggarwal 200 Mission Blvd, Jackson, CA 95642 INTERNAL MEDICINE
Steven Mills 12140 New York Ranch Rd, Jackson, CA 95642 FAMILY PRACTICE
David Bruce 817 Court St, Jackson, CA 95642 DERMATOLOGY
Christopher Sienes 665 New York Ranch Rd, Jackson, CA 95642 CHIROPRACTIC
Thomas Bowhay 1245 Jackson Gate Rd, Jackson, CA 95642 FAMILY PRACTICE
Drew Hood 200 Mission Blvd, Jackson, CA 95642 EMERGENCY MEDICINE
Yong Liu 200 Mission Blvd, Jackson, CA 95642 INTERNAL MEDICINE
Gary Woodward 815 Court St, Jackson, CA 95642 INTERNAL MEDICINE
Denise Mathre 12150 Industry Blvd, Jackson, CA 95642 CHIROPRACTIC
Vincent Lee 200 Mission Blvd, Jackson, CA 95642 INTERNAL MEDICINE
Karanbir Brar 200 Mission Blvd, Jackson, CA 95642 INTERNAL MEDICINE
Amir Jamali 200 Mission Blvd, Jackson, CA 95642 ORTHOPEDIC SURGERY
Pedram Shawd 200 Mission Blvd, Jackson, CA 95642 INTERNAL MEDICINE
Mandeep Singh 200 Mission Blvd, Jackson, CA 95642 NEPHROLOGY