Individual provider Active NPI

Mark A Eberle, M.D.

  • Specialist
  • New York, NY
National Provider Identifier
1194878652
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
60-163750 Issued in NY
Practice address
343 E 33Rd St
Ground Floor
New York, NY 10016-9400
Phone
(212) 679-0004
Fax
(212) 685-9526
NPI assigned
Jan 19, 2007
Sex
Male
Sole proprietor
Yes

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
Specialist 174400000X 60-163750 NY Primary

Addresses

Primary practice location

343 E 33Rd St
Ground Floor
New York, NY 10016-9400

Mailing address

401 E 86TH St
Apt 16C
New York, NY 10028-6403
Phone (212) 534-4804

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
I20110323000246 NY Practitioner - Rheumatology 4688857014 Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Icahn School of Medicine at Mount Sinai, 1984
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

335 E 33Rd St Level
New York, NY 10016-9453
Phone (212) 679-0004

Hospital & facility affiliations

  • NYU Langone Hospitals Hospital, New York, NY, CCN 330214

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60-163750NYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Healthcare Medical PC Specialist PastSince Apr 7, 2010 Accepting new patients

Organizations & group practices 1

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.

Hospital & facility affiliations 7

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": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194878652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E 86TH ST",
            "address_2": "APT 16C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100286403",
            "telephone_number": "212-534-4804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "343 E 33RD ST",
            "address_2": "GROUND FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100169400",
            "telephone_number": "212-679-0004",
            "fax_number": "212-685-9526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERLE",
        "first_name": "MARK",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "60-163750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.