Active NPI
Mark Carlin Homonoff, M.D.
- Neurology Physician
- Sleepy Hollow, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 124360
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 10
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01761100 | Medicaid | NY |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mhomonoff534397@Direct.FranciscanAlliance.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, MD, TX, LA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 4
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
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60855 | AZ | MD | Neurology Physician |
| G137693 | CA | MD | Neurology Physician |
| TPME235 | FL | MD | Neurology Physician |
| 86476 | GA | MD | Neurology Physician |
| 54443 | KY | MD | Neurology Physician |
| 2020-03485 | NC | MD | Neurology Physician |
| 0101268461 | VA | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healthtexas Provider Network | Current | Accepting new patients | |
| Ochsner Clinic LLC | Current | Accepting new patients | |
| Healthtexas Provider Network | Neurology | Current | Accepting new patients |
| Icahn School of Medicine at Mount Sinai | Current | Accepting new patients | |
| Ochsner Clinic LLC | Current | Accepting new patients | |
| Sinai Hospital of Baltimore, Inc. | Current | Accepting new patients | |
| Icahn School of Medicine at Mount Sinai | Current | Accepting new patients | |
| Sinai Hospital of Baltimore Inc | Current | Accepting new patients | |
| Sinai Hospital of Baltimore Inc | Current | Accepting new patients | |
| Ochsner Clinic LLC | Current | Accepting new patients | |
| North Shore-Lij Medical PC | Past | 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
- 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.
-
- Neurological Surgery Physician
- Newyork, NY
- NPI 1558627844
-
- General Practice Physician
- New Orleans, LA
- NPI 1538151428
-
- Surgical Critical Care Physician
- Baltimore, MD
- NPI 1043235666
-
- Eyewear Supplier
- New York, NY
- NPI 1760227466
-
- Anesthesiology Physician
- Lakeway, TX
- NPI 1104714583
-
- Registered Dietitian
- Covington, LA
- NPI 1013747039
-
- General Practice Physician
- Covington, LA
- NPI 1932432945
-
- General Acute Care Hospital
- Baltimore, MD
- NPI 1669497285
-
- General Acute Care Hospital
- Baltimore, MD
- NPI 1285672204
-
- Urology Physician
- Great Neck, NY
- NPI 1053688572
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- New York, NY
- NPI 1104982917
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.