Individual provider Active NPI

Mark Geoffrey Gresser, DPM

  • Podiatrist
  • Mount Sinai, NY
National Provider Identifier
1326056508
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N003743 Issued in NY
Practice address
626 Canal Rd
Mt Sinai, NY 11766
Phone
(631) 331-3338
Fax
(631) 331-0014
NPI assigned
Aug 4, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X N003743 NY Primary

Addresses

Primary practice location

626 Canal Rd
Mt Sinai, NY 11766

Mailing address

626 Canal Rd
Mt Sinai, NY 11766
Phone (631) 331-3338

Other identifiers 1

IdentifierTypeStateIssuer
00886888MedicaidNY

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

LicenseStateTypeSpecialty
003743NYMDBehavioral Analyst
N003743NYMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
North Country Podiatry Podiatrist PastSince Nov 16, 2011 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326056508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "626 CANAL RD",
            "city": "MT SINAI",
            "state": "NY",
            "postal_code": "11766",
            "telephone_number": "631-331-3338",
            "fax_number": "631-331-0014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 CANAL RD",
            "city": "MT SINAI",
            "state": "NY",
            "postal_code": "11766",
            "telephone_number": "631-331-3338",
            "fax_number": "631-331-0014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRESSER",
        "first_name": "MARK",
        "middle_name": "GEOFFREY",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N003743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00886888",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Sinai, 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.

Verify at the official NPI Registry.