MARK NOBLE SCHWENDIMAN (D.O.) – Dermatology Physician, NPI 1417184409

MARK NOBLE SCHWENDIMAN (D.O.) is a healthcare provider. based in Meridian, Idaho. specializing in DERMATOLOGY. They hold the professional credentials D.O.. They hold a License No. O1018 (ID). The NPI Number for MARK NOBLE SCHWENDIMAN (D.O.) is 1417184409

Main info

Male
Sole Proprietor
17 Years Of Experience
Accepts Medicare Assignment
Name
MARK NOBLE SCHWENDIMAN (D.O.)
NPI
1417184409
Phone
(208) 884-3376
Address
1618 S MILLENIUM WAY STE 100
Enumeration Date
17 June 2009
Last Update Date
4 June 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2088843376
Graduation Year
2009 (17 years ago)
PAC ID
6608151410
Group Practice PAC ID
1153341532
Professional Enrollment ID
I20170317001066
Address ID
ID836426457ME1618XWAYX401

Contacts

Secure Messaging
mark1@adawest.emadirect.md
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience56
Completeness85
Years active:16State licenses:1Other namesUpdated within 12 months

61 DERMATOLOGY in ID

Provider Addresses for MARK NOBLE SCHWENDIMAN (D.O.)

  • 1618 S MILLENIUM WAY STE 100

    MERIDIAN, ID 836426457

    Phone: (208) 884-3376

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

CMS reports 163 Open Payments records for all available years, with a total value of $3,459.

Total Amount is formed as General ($3,459) + Research ($0) + Ownership ($0) = $3,459.

Last reported payment date: 2024-12-17 • Largest payer in this snapshot: Regeneron Healthcare Solutions, Inc. ($712).

Total Amount

$3,459

General + Research + Ownership

Payments

163

Total payment records

General Amount

$3,459

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-17

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2017-03-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20170317001066IDermatologyIDTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
17003Destruction of precancer skin growth, 2-14 growths1,385264$0
99213Established patient office or other outpatient visit, 20-29 minutes673528$0
17000Destruction of precancer skin growth, 1 growth479326$0
11102Biopsy of related skin growth, first growth262202$0
11103Biopsy of related skin growth, each additional growth15275$0
View full utilization report →

Insurance plans in this area (ZIP 83642)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1153341532View full group profile
NameSpecialtyState
Physician AssistantID
Nurse PractitionerID
D E R M A T O L O G YAL
Physician AssistantID
D E R M A T O L O G YID
Physician AssistantMN
Physician AssistantID
Physician AssistantID
Physician AssistantID
Physician AssistantID

Reviews

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Frequently asked questions

What number should I use to identify MARK NOBLE SCHWENDIMAN (D.O.) for billing?
Administrative and clinical systems typically use NPI 1417184409 for MARK NOBLE SCHWENDIMAN (D.O.).
Is MARK NOBLE SCHWENDIMAN (D.O.) currently accepting referrals based on NPI status?
Registry metadata lists MARK NOBLE SCHWENDIMAN (D.O.) as active.
What services align with MARK NOBLE SCHWENDIMAN (D.O.)'s listing?
MARK NOBLE SCHWENDIMAN (D.O.)'s public classification highlights Dermatology Physician. Clinical services aligned with this taxonomy classification.
Which community is linked to MARK NOBLE SCHWENDIMAN (D.O.)?
MARK NOBLE SCHWENDIMAN (D.O.) shows a connection to Meridian, Idaho in registry-derived data.
Can I export MARK NOBLE SCHWENDIMAN (D.O.)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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