Active NPI
Mark Fornes, DC
- Chiropractor
- New York City, NY
National Provider Identifier
1265553309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- X0041411
- Practice address
- 125 W 16TH St
#117
New York City, NY 10011 - Phone
- (212) 741-9660
- Fax
- (212) 741-9660
- NPI assigned
- Apr 3, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | X0041411 | NY | Primary |
Addresses
Primary practice location
125 W 16TH St
#117
New York City, NY 10011
Mailing address
190 North Long Beach Ave
Freeport, NY 11520
Phone (516) 623-4397
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| X0041411 | NY | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1265553309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "190 NORTH LONG BEACH AVE",
"city": "FREEPORT",
"state": "NY",
"postal_code": "11520",
"telephone_number": "516-623-4397"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 W 16TH ST",
"address_2": "#117",
"city": "NEW YORK CITY",
"state": "NY",
"postal_code": "10011",
"telephone_number": "212-741-9660",
"fax_number": "212-741-9660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORNES",
"first_name": "MARK",
"name_prefix": "Mr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NY",
"license": "X0041411",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York City, 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.