Mara Phelan, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

312028 Issued in NY

Practice address

1824 Madison Ave FL 5
New York, NY 10035-3832

Phone

(212) 423-4500

NPI assigned

Apr 9, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Family Practice

Education

Albert Einstein College of Medicine of Yeshiva University, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Institute for Family HealthGroup PAC ID 9234048588, 188 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles (3 of 7)

Locations

Networks

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

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.

• The Institute for Family Health

  • Family Medicine Physician
  • New York, NY
  • NPI 1295729408

  Family Medicine, NY

  Medicare reassignment NPD
• Care for the Homeless

  • Federally Qualified Health Center (FQHC)
  • Bronx, NY
  • NPI 1013154657

  NY

  Medicare reassignment
• The Institute for Family Health

  • Family Medicine Physician
  • Kingston, NY
  • NPI 1194098251

  Family Medicine

  NPD
• The Institute for Family Health

  • Family Medicine Physician
  • New York, NY
  • NPI 1972877017

  Family Medicine

  NPD

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

{
    "created_epoch": "1554768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1306309018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1824 MADISON AVE FL 5",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100353832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1824 MADISON AVE FL 5",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100353832",
            "telephone_number": "212-423-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELAN",
        "first_name": "MARA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-09",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "312028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeremy Pheiffer, LMT
• Sherman Pheiffer, LCSW, LP
• Daniel Joseph Phelan, MD
• Kelsie Jean Phelan
• Madeleine Blaine Phelan, LMSW
• Mary P. Phelan, LMSW
• Phelps Memorial Hospital
• Brooke Phelps, LCSW
• Emily Broman Phelps, MD
• Grace Phelps, RBT

• All providers in New York, NY
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; 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.