NPIMap

Individual provider Active NPI

Dale Mark-Andrew Runcie, MD

  • Emergency Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1316100183
Registry record updated Apr 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD470913 Issued in PA
Practice address
760 Broadway
Woodhull Medical & Mental Health Center
Brooklyn, NY 11206
Phone
(718) 963-8000
Fax
(215) 762-1470
NPI assigned
Jul 2, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 271428 NY
Emergency Medicine Physician 207P00000X MD470913 PA Primary

Addresses

Primary practice location

760 Broadway
Woodhull Medical & Mental Health Center
Brooklyn, NY 11206

Mailing address

PO Box 783311
Philadelphia, PA 19178-3311
Phone (484) 884-4500

Other practice location 1

700 E Broad St
Hazleton, PA 18201-6835
Phone (570) 501-4193

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210818002843 PA Practitioner - Emergency Medicine 9032410196 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

1200 S Cedar Crest Blvd
LVPG Emergency Medicine
Allentown, PA 18103-6202
Phone (610) 402-8111

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
271428NYMDEmergency Medicine Physician
MD470913PAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group Emergency Medicine Current Accepting new patients
Lehigh Valley Physician Group CurrentSince Mar 1, 2022 Accepting new patients
Pennsylvania Physician Services, LLC Emergency Medicine CurrentSince Jul 1, 2021 Accepting new patients
Pennsylvania Physician Services, LLC Emergency Medicine Current Accepting new patients
Pennsylvania Physician Services, LLC Emergency Medicine CurrentSince Jul 1, 2021 Accepting new patients
Lehigh Valley Physician Group CurrentSince Mar 1, 2022 Accepting new patients

Locations

1200 S Cedar Crest Blvd
Allentown, PA 18103
Phone (484) 862-3200

700 E Broad St
Hazleton, PA 18201
Phone (570) 501-4000

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

746 Jefferson Ave
Scranton, PA 18510
Phone (570) 340-5079

575 N River St
Wilkes Barre, PA 18764
Phone (570) 552-1300

Networks

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

Interoperability endpoints

  • Direct secure messaging: druncie629517@direct2.lvhn.org
  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 7

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 5

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": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649808000000",
    "number": "1316100183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 783311",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191783311",
            "telephone_number": "484-884-4500",
            "fax_number": "484-884-0699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 BROADWAY",
            "address_2": "WOODHULL MEDICAL & MENTAL HEALTH CENTER",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11206",
            "telephone_number": "718-963-8000",
            "fax_number": "215-762-1470"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 E Broad St",
            "address_purpose": "LOCATION",
            "city": "Hazleton",
            "state": "PA",
            "postal_code": "182016835",
            "country_code": "US",
            "telephone_number": "570-501-4193",
            "fax_number": "570-501-4109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUNCIE",
        "first_name": "DALE",
        "middle_name": "MARK-ANDREW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-02",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "271428",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD470913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.