Individual provider Active NPI

Mark Jeffrey Drukartz, DDS

  • General Practice Dentistry
  • Brooklyn, NY
National Provider Identifier
1003807975
Registry record updated Apr 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0404331 Issued in NY
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

Updated by the provider on Apr 11, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
02514529MedicaidNY

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151117002545 NY Order and Referring Only - DentistPractitioner - Dentist 7113237496

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0404331NYMDGeneral Practice Dentistry

Interoperability endpoints

  • FHIR API: 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

Verify at the official NPI Registry.