Mark Howard Tannenbaum, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

181665 Issued in NY

Practice address

87 Grandview Ave
Waterbury, CT 06708-2514

Phone

(203) 574-2020

Fax

(203) 596-2230

NPI assigned

Jan 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Mark H Tannenbaum Professional name

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

Specialty

Ophthalmology

Education

Albert Einstein College of Medicine of Yeshiva University, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Icahn School of Medicine at Mount SinaiGroup PAC ID 2264691070, 2,809 clinicians

Chinatown True Care Medical PLLCGroup PAC ID 2163859760, 245 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ny Eye and Ear Infirmary of Mount Sinai Hospital, New York, NY, CCN 330100

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: mtannenbaum1169449@nychhc.direct-ci.com
• Direct secure messaging: mtannenbaum@refocus.intellechartdirect.net

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.

• Chinatown True Care Medical PLLC

  • Internal Medicine Physician
  • New York, NY
  • NPI 1912567884
  Medicare reassignment Care Compare group NPD
• Icahn School of Medicine at Mount Sinai

  • Ophthalmology Physician
  • New York, NY
  • NPI 1437421252
  Medicare reassignment Care Compare group NPD
• Harvey Rosenblum, MD,PC

  • Ophthalmology Physician
  • New York, NY
  • NPI 1457404733
  Medicare reassignment NPD
• Icahn School of Medicine at Mount Sinai

  • Eyewear Supplier
  • New York, NY
  • NPI 1760227466

  Ophthalmology

  NPD
• Union Square Eye Center LLC

  • Ophthalmology Physician
  • New York, NY
  • NPI 1285105866
  NPD
• Coney Island Family Eyecare

  • Optometrist
  • Brooklyn, NY
  • NPI 1821154378
  NPD (past)
• Rona Appel MD PC

  • Ophthalmology Physician
  • Brooklyn, NY
  • NPI 1922321280
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• New York Eye & Ear Infirmary

  • Special Hospital
  • New York City, NY
  • NPI 1245251222
  Care Compare affiliation

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1285613273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 GRANDVIEW AVE",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082514",
            "telephone_number": "203-574-2020",
            "fax_number": "203-596-2230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 GRANDVIEW AVE",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082514",
            "telephone_number": "203-574-2020",
            "fax_number": "203-596-2230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "94 Bowery",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100134888",
            "country_code": "US",
            "telephone_number": "212-335-0328",
            "fax_number": "212-335-0320",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "749 61st St Fl 6",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112205162",
            "country_code": "US",
            "telephone_number": "718-362-6311",
            "fax_number": "718-362-6312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANNENBAUM",
        "first_name": "MARK",
        "middle_name": "HOWARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CT",
            "license": "64133",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "181665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARK",
            "last_name": "TANNENBAUM",
            "middle_name": "H",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Donna Tanganelli
• Amanda Tangney, LPC
• Lisa Marie Tanguay, PA
• Robert Tanguay, CPHT
• Avantika Tankala
• Maryam Tanweer, MD
• Sandra Tapia-Arcos, LCSW
• Gais Tarat, MD
• Emily Tarini, OT
• Snober Tariq, DMD

• Ophthalmology Physician in Waterbury, CT
• Providers in Waterbury, CT by specialty
• Ophthalmology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.