Active NPI
Mark K Hirko, MD
- Vascular Surgery Physician
- Poughkeepsie, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- 288898
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0368954 | Medicaid | NJ | |
| 04773300 | Medicaid | NY |
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 288898 | NY | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nuvance Health Medical Practice PC | Current | 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.
-
- Internal Medicine Physician
- Poughkeepsie, NY
- NPI 1437358033
-
- Emergency Medical Services (Emergency Medicine) Physician
- Springfield, MA
- NPI 1548205909
Surgery
-
- Vascular Surgery Physician
- Springfield, MA
- NPI 1174721336
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2018; 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.