Individual provider Active NPI

Mark Elliott Hupart, DPM

  • Podiatrist
  • Brooklyn, NY
National Provider Identifier
1306911680
Registry record updated Jan 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N004686 Issued in NY
Practice address
2123 E 70TH St
Brooklyn, NY 11234-6101
Phone
(718) 241-2000
Fax
(718) 241-2000
NPI assigned
Nov 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X N004686 NY Primary

Addresses

Primary practice location

2123 E 70TH St
Brooklyn, NY 11234-6101

Mailing address

2123 E 70TH St
Brooklyn, NY 11234
Phone (718) 241-5764

Other identifiers 4

IdentifierTypeStateIssuer
06719OtherNYMEDICARE GHI
1306911680OtherNYMEDICARE
01180363MedicaidNY
1306911680MedicaidNY

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040416000180 NY Practitioner - Podiatry 4789679135 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1989
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2123 E 70TH St
Brooklyn, NY 11234-6101
Phone (718) 241-2000

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue909

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
N004686NYMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mark Elliott Hupart Doctor of Podiatric Medicine LLC Podiatrist CurrentSince Dec 20, 2010 Accepting new patients
Southside Podiatry PC Podiatrist CurrentSince Feb 1, 1995 Accepting new patients

Locations

903 E 82nd St
Brooklyn, NY 11236
Phone (347) 721-4736

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": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515369600000",
    "number": "1306911680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2123 E 70TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11234",
            "telephone_number": "718-241-5764",
            "fax_number": "718-241-5764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2123 E 70TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112346101",
            "telephone_number": "718-241-2000",
            "fax_number": "718-241-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUPART",
        "first_name": "MARK",
        "middle_name": "ELLIOTT",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2018-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N004686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GHI",
            "identifier": "06719",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1306911680",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01180363",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306911680",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.