Individual provider Active NPI

Mark Carlin Homonoff, M.D.

  • Neurology Physician
  • Sleepy Hollow, NY
National Provider Identifier
1003934035
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
124360 Issued in NY
Practice address
755 N Broadway Ste 417
Sleepy Hollow, NY 10591-1083
Phone
(914) 366-5330
NPI assigned
Mar 27, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2022

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

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X TPME235 FL
Neurology Physician 2084N0400X 54443 KY
Neurology Physician 2084N0400X 86476 GA
Neurology Physician 2084N0400X 60855 AZ
Neurology Physician 2084N0400X 01084726A IN
Neurology Physician 2084N0400X 2020-03485 NC
Neurology Physician 2084N0400X 0101268461 VA
Neurology Physician 2084N0400X G137693 CA
Neurology Physician 2084N0400X Q8908 TX
Neurology Physician 2084N0400X 124360 NY Primary

Addresses

Primary practice location

755 N Broadway Ste 417
Sleepy Hollow, NY 10591-1083

Mailing address

70 Riverside Dr Apt 6H
New York, NY 10024-5716
Phone (212) 580-8235

Other practice location 1

1701 S Creasy Ln
Lafayette, IN 47905-4972
Phone (765) 502-4400

Other identifiers 1

IdentifierTypeStateIssuer
01761100MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mhomonoff534397@Direct.FranciscanAlliance.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MD, TX, LA4 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20120223000750 NY Practitioner - NeurologyPractitioner - Internal Medicine 3274791199 Reassigns benefits to 1 organization
I20160429000327 MD Practitioner - Neurology 3274791199 Reassigns benefits to 1 organization
I20161216001899 TX Practitioner - Neurology 3274791199 Reassigns benefits to 1 organization
I20210224001107 LA Practitioner - Neurology 3274791199 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Albert Einstein College of Medicine of Yeshiva University, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Icahn School of Medicine at Mount SinaiGroup PAC ID 2264691070, 2,809 clinicians

Practice addresses (Care Compare)

1 Gustave Levy Place
Mount Sinai Emergency Room
New York, NY 10029-6500
Phone (212) 241-4572

1111 Amsterdam Ave
New York, NY 10025-1716
Phone (212) 523-2400

5 E 98TH St 2ND FL
New York, NY 10029-6501
Phone (212) 241-4572

Hospital & facility affiliations

  • Mount Sinai West Hospital, New York, NY, CCN 330046

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
60855AZMDNeurology Physician
G137693CAMDNeurology Physician
TPME235FLMDNeurology Physician
86476GAMDNeurology Physician
54443KYMDNeurology Physician
2020-03485NCMDNeurology Physician
0101268461VAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Oct 18, 2016 Accepting new patients
Ochsner Clinic LLC CurrentSince Jan 8, 2021 Accepting new patients
Healthtexas Provider Network Neurology CurrentSince Oct 18, 2016 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Mar 6, 2013 Accepting new patients
Ochsner Clinic LLC Current Accepting new patients
Sinai Hospital of Baltimore, Inc. CurrentSince Mar 19, 2016 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Mar 6, 2013 Accepting new patients
Sinai Hospital of Baltimore Inc CurrentSince Mar 19, 2016 Accepting new patients
Sinai Hospital of Baltimore Inc Current Accepting new patients
Ochsner Clinic LLC CurrentSince Jan 8, 2021 Accepting new patients
North Shore-Lij Medical PC PastSince Dec 22, 2020 Accepting new patients

Locations

17000 Medical Center Dr
Baton Rouge, LA 70816
Phone (225) 752-2470

1514 Jefferson Hwy
New Orleans, LA 70121

104 Acadia Park Dr
Raceland, LA 70394
Phone (985) 537-3211

5051 Greenspring Ave
Baltimore, MD 21209
Phone (410) 601-1441

5 E 98th St
Fl 5
New York, NY 10029
Phone (212) 241-8234

777 N Broadway
Ste 305
Sleepy Hollow, NY 10591
Phone (914) 366-6120

8080 N Central Expy
Ste 600
Dallas, TX 75206
Phone (972) 860-8648

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

3600 Gaston Ave
Ste 1155
Dallas, TX 75246
Phone (214) 820-4688

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: mhomonoff534397@direct.franciscanalliance.org

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1003934035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 RIVERSIDE DR APT 6H",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100245716",
            "telephone_number": "212-580-8235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 N BROADWAY STE 417",
            "city": "SLEEPY HOLLOW",
            "state": "NY",
            "postal_code": "105911083",
            "telephone_number": "914-366-5330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 S Creasy Ln",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "IN",
            "postal_code": "479054972",
            "country_code": "US",
            "telephone_number": "765-502-4400",
            "fax_number": "765-502-4401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOMONOFF",
        "first_name": "MARK",
        "middle_name": "CARLIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "TPME235",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "KY",
            "license": "54443",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "GA",
            "license": "86476",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AZ",
            "license": "60855",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IN",
            "license": "01084726A",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NC",
            "license": "2020-03485",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "VA",
            "license": "0101268461",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "G137693",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TX",
            "license": "Q8908",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "124360",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01761100",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mhomonoff534397@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1701 S Creasy Ln",
            "city": "Lafayette",
            "state": "IN",
            "country_code": "US",
            "postal_code": "479054972",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sleepy Hollow, NY

Sources for this page

Verify at the official NPI Registry.