Individual provider Active NPI

Mark Rogers, M.D.,

  • Emergency Medicine Physician
  • New York, NY
National Provider Identifier
1104918895
Registry record updated Feb 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
161009 Issued in NY
Practice address
100 E 77TH St
Emergency Department
New York, NY 10075-1850
Phone
(212) 434-2650
NPI assigned
Sep 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 161009 NY Primary

Addresses

Primary practice location

100 E 77TH St
Emergency Department
New York, NY 10075-1850

Mailing address

2800 Marcus Ave
Emergency Department
New Hyde Park, NY 11042-1113
Phone (212) 434-2650

Other identifiers 1

IdentifierTypeStateIssuer
01463038MedicaidNY

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)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Beth Israel Medical Center Past Accepting new patients
KHH Emergency Medicine Emergency Medicine Past Accepting new patients
LH Emergency Medical Services PC Emergency Medicine Past Accepting new patients
Park Lenox Emergency Medicine, PC Emergency Medicine Past Accepting new patients
St. Vincent'S Emergency Services PC Emergency Medicine Past Accepting new patients
Beth Israel Medical Center Emergency Medicine Past Accepting new patients
Prohealth Care Associates LLP Past Accepting new patients

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456704000000",
    "number": "1104918895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 MARCUS AVE",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421113",
            "telephone_number": "212-434-2650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E 77TH ST",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100751850",
            "telephone_number": "212-434-2650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "MARK",
        "credential": "M.D.,",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2016-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "161009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01463038",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2016; 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.