MARK WATHEN (MD) – Clinical Cardiac Electrophysiology Physician, NPI 1104925536

MARK WATHEN (MD) is a healthcare provider. based in Cookeville, Tennessee. specializing in CARDIAC ELECTROPHYSIOLOGY. They hold the professional credentials MD. They hold a License No. 23921 (TN). The NPI Number for MARK WATHEN (MD) is 1104925536

Main info

Male
42 Years Of Experience
Accepts Medicare Assignment
Name
MARK WATHEN (MD)
NPI
1104925536
Phone
(931) 372-0405
Address
228 W 4TH ST
Enumeration Date
22 September 2006
Last Update Date
17 June 2022

Doctor Profile

Medical School Name
LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS
Secondary Phone
9313720405
Graduation Year
1984 (42 years ago)
PAC ID
8426032608
Group Practice PAC ID
1052332830
Professional Enrollment ID
I20040615001483
Address ID
TN385012489CO228XXSTXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience72
Completeness75
Years active:19State licenses:1Digital endpointsOther names

91 CARDIAC ELECTROPHYSIOLOGY in TN

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Provider Addresses for MARK WATHEN (MD)

  • 228, West 4th Street, Cookeville, Putnam County, Tennessee, 38501, United States

    SUITE 200

    COOKEVILLE, TN 385012488

    Phone: (931) 372-0405

    Fax: (931) 372-0463

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 36 Open Payments records for all available years, with a total value of $2,582.

Total Amount is formed as General ($2,582) + Research ($0) + Ownership ($0) = $2,582.

Last reported payment date: 2024-12-23 • Largest payer in this snapshot: Medtronic, Inc. ($1,619).

Total Amount

$2,582

General + Research + Ownership

Payments

36

Total payment records

General Amount

$2,582

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-23

Latest reported date

Top Companies

Largest payers in this snapshot

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: 2004-06-15

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
I20040615001483ICardiac ElectrophysiologyTNTBD

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
93296Evaluation of single, dual, multiple lead or leadless pacemaker system or implantable defibrillator system, remote up to 90 days1,346557$0
93000Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report941825$0
93294Evaluation of single, dual, multiple lead or leadless pacemaker system, remote up to 90 days893372$0
93295Evaluation of single, dual, or multiple lead implantable defibrillator system, remote up to 90 days457186$0
85610Blood test, clotting time38930$0
View full utilization report →

Insurance plans in this area (ZIP 38501)

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Provider's Procedures

MARK WATHEN (MD) performs procedures in CARDIAC ELECTROPHYSIOLOGY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
CARDIAC ELECTROPHYSIOLOGYTN93010Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report19201419
CARDIAC ELECTROPHYSIOLOGYTN93284Evaluation, testing and programming adjustment of defibrillator with analysis, review and report11882

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: 1052332830View full group profile
NameSpecialtyState
Cardiovascular Disease (Cardiology)TN
Interventional Cardiology, Cardiovascular Disease (Cardiology)TN
Internal Medicine, Cardiovascular Disease (Cardiology)TN
-TN
Interventional Cardiology, Cardiovascular Disease (Cardiology)TN
Cardiovascular Disease (Cardiology)TN
Cardiac Electrophysiology, Cardiovascular Disease (Cardiology)TN
Nurse PractitionerTN
Cardiovascular Disease (Cardiology), Interventional CardiologyLA
Cardiovascular Disease (Cardiology)FL

Reviews

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Frequently asked questions

What is the standard ID for MARK WATHEN (MD) in the U.S.?
In the U.S., MARK WATHEN (MD) is identified by NPI 1104925536.
Does the public listing show MARK WATHEN (MD) as active?
MARK WATHEN (MD)'s NPI record reflects an active status in NPPES.
What does the directory say MARK WATHEN (MD) does?
Insurance directories may phrase it differently, but here MARK WATHEN (MD) maps to Clinical Cardiac Electrophysiology Physician. Clinical services aligned with this taxonomy classification.
Which community is linked to MARK WATHEN (MD)?
MARK WATHEN (MD) shows a connection to Cookeville, Tennessee in registry-derived data.
Why is information missing for MARK WATHEN (MD)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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