Active NPI
Mark Jeffrey Drukartz, DDS
- General Practice Dentistry
- Brooklyn, NY
National Provider Identifier
1003807975
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 0404331
- Practice address
- 585 Schenectady Ave
Brooklyn, NY 11203-1809 - Phone
- (718) 604-5000
- NPI assigned
- Oct 31, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 0404331 | NY | Primary |
Addresses
Primary practice location
585 Schenectady Ave
Brooklyn, NY 11203-1809
Mailing address
11034 73Rd Rd
Forest Hills, NY 11375-6322
Phone (171) 826-3816
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02514529 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151117002545 | NY | Order and Referring Only - Dentist | 7113237496 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0404331 | NY | MD | General Practice Dentistry |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/BEBAED/Endpoint/BEBAED
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334102400000",
"number": "1003807975",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11034 73RD RD",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113756322",
"telephone_number": "171-826-3816"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "585 SCHENECTADY AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112031809",
"telephone_number": "718-604-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DRUKARTZ",
"first_name": "MARK",
"middle_name": "JEFFREY",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-31",
"last_updated": "2012-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "0404331",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02514529",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.