Active NPI
Marc Mentis, M.D.
- Psychiatry Physician
- West Brentwood, NY
National Provider Identifier
1023156452
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 208771
- Practice address
- 998 Crooked Hill Rd
West Brentwood, NY 11717-1043 - Phone
- (631) 761-3016
- NPI assigned
- Feb 1, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 208771 | NY | Primary |
Addresses
Primary practice location
998 Crooked Hill Rd
West Brentwood, NY 11717-1043
Mailing address
1 Christopher CT
Melville, NY 11747-1829
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 287711 | NY | MD | Licensed Practical Nurse |
| 208771 | NY | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1023156452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CHRISTOPHER CT",
"city": "MELVILLE",
"state": "NY",
"postal_code": "117471829"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "998 CROOKED HILL RD",
"city": "WEST BRENTWOOD",
"state": "NY",
"postal_code": "117171043",
"telephone_number": "631-761-3016"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENTIS",
"first_name": "MARC",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "208771",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Brentwood, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.