Individual provider Active NPI

Scott Andrew Mark, DC

  • Chiropractor
  • New York, NY
National Provider Identifier
1164535290
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X008059-1 Issued in NY
Practice address
61 Broadway
Suite 900
New York, NY 10006-2701
Phone
(212) 248-0077
Fax
(212) 747-0939
NPI assigned
Aug 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X008059-1 NY Primary

Addresses

Primary practice location

61 Broadway
Suite 900
New York, NY 10006-2701

Mailing address

120 Christopher CT
Woodbury, NY 11797-1250

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

State licenses

LicenseStateTypeSpecialty
X008059-1NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Wellness of Jericho PC Chiropractor Current Accepting new patients
Wall Street Physical Medicine & Rehabilitation, P.C. Current Accepting new patients

Locations

99 Jericho Tpke
Ste 100
Jericho, NY 11753
Phone (516) 280-8044

61 Broadway
Rm 900
New York, NY 10006
Phone (212) 248-0077

Organizations & group practices 2

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": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164535290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 CHRISTOPHER CT",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117971250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 BROADWAY",
            "address_2": "SUITE 900",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100062701",
            "telephone_number": "212-248-0077",
            "fax_number": "212-747-0939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARK",
        "first_name": "SCOTT",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X008059-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 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.

Verify at the official NPI Registry.