Mark A Edelman, M.D.

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

51858 Issued in CT

Practice address

1290 Summer St Ste 2100
Stamford, CT 06905-5340

Phone

(855) 830-8346

NPI assigned

Aug 26, 2005

Last updated

Jun 4, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in NY, CT2 enrollments

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 2

Specialty

Interventional Radiology

Education

New York University School of Medicine, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Center for Vein Restoration CT LLCGroup PAC ID 8820232713, 7 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: mark.edelman.p5@direct.cvr.nextgenshare.com

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.

• Center for Vein Restoration CT LLC

  • Vascular Surgery Physician
  • Stamford, CT
  • NPI 1306282926
  Medicare reassignment Care Compare group NPD
• VR Physician for Vein Restoration

  • Vascular Surgery Physician
  • Scarsdale, NY
  • NPI 1700122728
  Medicare reassignment NPD
• Center for Vein Restoration CT LLC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Waterbury, CT
  • NPI 1265300560
  NPD
• VR Physician for Vein Restoration

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Bronx, NY
  • NPI 1063373009
  NPD
• Central Illinois Neuroradiology, LTD

  • Specialist
  • Bloomington, IL
  • NPI 1881641371
  NPD (past)
• Endeavor Health Medical Group

  dba NorthShore Anesthesia Group

  • Anesthesiology Physician
  • Evanston, IL
  • NPI 1265695944
  NPD (past)
• Endeavor Health Medical Group

  dba NorthShore University HealthSystem Faculty Practice Associates

  • Allergy & Immunology Physician
  • Evanston, IL
  • NPI 1497701882
  NPD (past)
• Global Medical Imaging, SC

  • Diagnostic Radiology Physician
  • Libertyville, IL
  • NPI 1144217142
  NPD (past)
• Illinois Phlebology Associates SC

  • Surgery Physician
  • Orland Park, IL
  • NPI 1154378040

  Vascular & Interventional Radiology

  NPD (past)
• Missouri Phlebology Inc

  • Vascular Surgery Physician
  • Kansas City, MO
  • NPI 1932155389

  Vascular & Interventional Radiology

  NPD (past)
• Skokie Valley Radiologist

  • Radiology Clinic/Center
  • Skokie, IL
  • NPI 1205838828
  NPD (past)

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559606400000",
    "number": "1063405819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 WESTCHESTER AVE",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106042901",
            "telephone_number": "914-682-6430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1290 SUMMER ST STE 2100",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069055340",
            "telephone_number": "855-830-8346"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40 Cross St Ste 320",
            "address_purpose": "LOCATION",
            "city": "Norwalk",
            "state": "CT",
            "postal_code": "068514661",
            "country_code": "US",
            "telephone_number": "855-830-8346",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "700 White Plains Rd Ste 241",
            "address_purpose": "LOCATION",
            "city": "Scarsdale",
            "state": "NY",
            "postal_code": "105835013",
            "country_code": "US",
            "telephone_number": "855-830-8346",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDELMAN",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-26",
        "last_updated": "2019-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036094621",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CT",
            "license": "51858",
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "IL",
            "license": "036094621",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NY",
            "license": "172012-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01301766",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "202926",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "212545",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008047540",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036094621",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eazy Prickz LLC (Eazy Prickz Mobile Solutions)
• Michael Irwin Ebright, M.D.
• Lindsay Eccleston, LMSW
• Echc LLC (Elder Care Homecare)
• Eclectic Balance LLC
• Jill Ramsey Edgar, PH.D.
• Edward Shukovsky
• Kristin Elaine Edwards
• Edwin F. Richter, III, MD, LLC
• Effective ABA

• Vascular & Interventional Radiology Physician in Stamford, CT
• Providers in Stamford, CT by specialty
• Vascular & Interventional Radiology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2019; 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.

Verify at the official NPI Registry.