Individual provider Active NPI

Mark Schreck

  • Orthopaedic Surgery Physician
  • Binghamton, NY
National Provider Identifier
1043630551
Registry record updated Jun 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
304612 Issued in NY
Practice address
65 Pennsylvania Ave
Binghamton, NY 13903-1651
Phone
(607) 723-5393
NPI assigned
Apr 23, 2014
Last updated
Jun 4, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Orthopaedic Surgery Physician 207X00000X 304612 NY Primary

Addresses

Primary practice location

65 Pennsylvania Ave
Binghamton, NY 13903-1651

Mailing address

2501 Foxwood LN
Vestal, NY 13850-2951
Phone (607) 206-6830

Other practice location 1

2501 Foxwood Ln
Vestal, NY 13850-2951
Phone (607) 206-6830

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20200819001659 NY Practitioner - Orthopedic Surgery 4587914429 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Albany Medical College of Union University, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

240 Riverside Dr
Johnson City, NY 13790-2732
Phone (607) 798-9356

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
304612NYMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of Lourdes Memorial Hospital, Inc. Family Medicine Current Accepting new patients
Our Lady of Lourdes Memorial Hospital Inc. CurrentSince Sep 15, 2020 Accepting new patients
Our Lady of Lourdes Memorial Hospital, Inc. CurrentSince Sep 15, 2020 Accepting new patients
Twin Tier Pathology Associates, PC Current Accepting new patients

Locations

169 Riverside Dr
Binghamton, NY 13905
Phone (607) 798-5111

169 Riverside Dr
Ste 206
Binghamton, NY 13905
Phone (607) 798-6701

65 Pennsylvania Ave
Binghamton, NY 13903
Phone (607) 723-5393

240 Riverside Dr
Johnson City, NY 13790
Phone (607) 754-3863

Interoperability endpoints

  • Direct secure messaging: mschreck196860@direct-guthrie.org

Organizations & group practices 4

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

Hospital & facility affiliations 1

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": "1398211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591228800000",
    "number": "1043630551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 FOXWOOD LN",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138502951",
            "telephone_number": "607-206-6830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 PENNSYLVANIA AVE",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139031651",
            "telephone_number": "607-723-5393"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2501 Foxwood Ln",
            "address_purpose": "LOCATION",
            "city": "Vestal",
            "state": "NY",
            "postal_code": "138502951",
            "country_code": "US",
            "telephone_number": "607-206-6830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHRECK",
        "first_name": "MARK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-23",
        "last_updated": "2020-06-04",
        "certification_date": "2020-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "304612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Binghamton, NY

Sources for this page

Verify at the official NPI Registry.