Individual provider Active NPI

Mark K Hirko, MD

  • Vascular Surgery Physician
  • Poughkeepsie, NY
National Provider Identifier
1023085107
Registry record updated Jun 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
288898 Issued in NY
Practice address
21 Reade PL Ste 3100
Poughkeepsie, NY 12601
Phone
(845) 214-1800
NPI assigned
Mar 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 288898 NY
Vascular Surgery Physician 2086S0129X 288898 NY Primary

Addresses

Primary practice location

21 Reade PL Ste 3100
Poughkeepsie, NY 12601

Mailing address

1351 Route 55 Ste 200
Lagrangeville, NY 12540-5144
Phone (845) 475-9661

Other practice location 1

300 2nd Ave
Long Branch, NJ 07740-6303
Phone (732) 923-6770

Other identifiers 2

IdentifierTypeStateIssuer
0368954MedicaidNJ
04773300MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
288898NYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nuvance Health Medical Practice PC CurrentSince May 15, 2017 Accepting new patients
Baystate Medical Practices, Inc Surgery Past Accepting new patients
Baystate Vascular Services, Inc Vascular Surgery Past Accepting new patients

Locations

1351 Route 55
Ste 200
Lagrangeville, NY 12540
Phone (845) 475-9622

45 Reade Pl
Fl 2
Poughkeepsie, NY 12601
Phone (845) 483-6001

21 Reade Pl
Ste 3100
Poughkeepsie, NY 12601
Phone (845) 214-1800

45 Reade Pl
Poughkeepsie, NY 12601
Phone (845) 331-3131

21 Reade Pl
Ste 3100A
Poughkeepsie, NY 12601
Phone (845) 214-1900

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529971200000",
    "number": "1023085107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1351 ROUTE 55 STE 200",
            "city": "LAGRANGEVILLE",
            "state": "NY",
            "postal_code": "125405144",
            "telephone_number": "845-475-9661",
            "fax_number": "845-475-9938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 READE PL STE 3100",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "12601",
            "telephone_number": "845-214-1800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 2nd Ave",
            "address_purpose": "LOCATION",
            "city": "Long Branch",
            "state": "NJ",
            "postal_code": "077406303",
            "country_code": "US",
            "telephone_number": "732-923-6770",
            "fax_number": "732-923-6768",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HIRKO",
        "first_name": "MARK",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-07",
        "last_updated": "2018-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "288898",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NY",
            "license": "288898",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0368954",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04773300",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

Verify at the official NPI Registry.