Evelyn Mark, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

007989 Issued in NY

Practice address

1 Brookdale PLZ
Emergency Department
Brooklyn, NY 11212-3139

Phone

(718) 240-5180

NPI assigned

Apr 22, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Brookdale Hospital Medical Center

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1962451195
  NPD (past)

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

{
    "created_epoch": "1177200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190937600000",
    "number": "1093933673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 MARCUS DR",
            "address_2": "PROVIDER ENROLLMENT",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117474230",
            "telephone_number": "631-391-7889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BROOKDALE PLZ",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112123139",
            "telephone_number": "718-240-5180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARK",
        "first_name": "EVELYN",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-22",
        "last_updated": "2007-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "007989",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00287218",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark Russell MD PC
• Mark Zelnick Inc
• Christine Angella Mark-Duruaku
• Alexander Mark
• Arlene V Mark, LPN
• Ian Solomon Mark, DMD
• January Tara Mark, MA, CCC-SLP
• Marilyn Mark
• Mary Mark
• Monique Mark

• Physician Assistant in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.

Verify at the official NPI Registry.