Individual provider Active NPI

Mark P Ghassibi, MD

  • Retina Specialist (Ophthalmology) Physician
  • New York, NY
National Provider Identifier
1356871230
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
311158 Issued in NY
Practice address
1000 10TH Ave
New York, NY 10019-1147
Phone
(212) 523-4000
NPI assigned
Jun 14, 2017
Last updated
Oct 11, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NY
Ophthalmology Physician 207W00000X 311158 NY
Retina Specialist (Ophthalmology) Physician 207WX0107X 311158 NY Primary

Addresses

Primary practice location

1000 10TH Ave
New York, NY 10019-1147

Mailing address

118 Maple Ave
Closter, NJ 07624-3125
Phone (201) 916-3023

Other practice location 1

1111 Amsterdam Ave
New York, NY 10025-1716
Phone (212) 523-4000

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230830002989 NY Practitioner - Ophthalmology 5698019404 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
George Washington University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amboy Medical Practice PCGroup PAC ID 2860538170, 171 clinicians

Practice addresses (Care Compare)

1058 Forest Ave
Staten Island, NY 10310-2419
Phone (718) 818-1058

1520 Flatbush Ave
Brooklyn, NY 11210-2450
Phone (718) 270-1714

26 Court St
Brooklyn, NY 11242-0103
Phone (718) 780-1530

4434 Amboy Rd
Staten Island, NY 10312-3845
Phone (718) 984-9658

450 Clarkson Ave
Brooklyn, NY 11203-2012
Phone (718) 270-1714

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
71.48 of 100Reported as apm
Quality
82.91
Promoting interoperability
5.67
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
311158NYMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Be Well Primary Health Care Center, LLC CurrentSince Dec 10, 2023 Accepting new patients
Amboy Medical Practice PC CurrentSince Sep 1, 2023 Accepting new patients
University Physicians of Brooklyn, Inc. Ophthalmology CurrentSince Jul 1, 2023 Accepting new patients
Goldstep Ambulatory Surgery Center, LLC CurrentSince Oct 4, 2023 Accepting new patients
University Physicians of Brooklyn, Inc. CurrentSince Jul 1, 2023 Accepting new patients
Amboy Medical Practice PC Ophthalmology CurrentSince Sep 1, 2023 Accepting new patients
University Physicians of Brooklyn, Inc Past Accepting new patients
New York City Health and Hospitals Corporation Past Accepting new patients

Locations

3007 Farragut Rd
Brooklyn, NY 11210
Phone (347) 915-1177

450 Clarkson Ave
Brooklyn, NY 11203
Phone (718) 270-1603

450 Clarkson Ave
#80
Brooklyn, NY 11203
Phone (718) 613-8481

4434 Amboy Rd
Staten Island, NY 10312
Phone (718) 818-1015

Networks

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

Interoperability endpoints

  • Direct secure messaging: mghassibi@uoc.direct.eyemdemr.com
  • Direct secure messaging: mghassibi361988@nychhc.direct-ci.com

Organizations & group practices 8

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.

Hospital & facility affiliations 2

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": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1356871230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 MAPLE AVE",
            "city": "CLOSTER",
            "state": "NJ",
            "postal_code": "076243125",
            "telephone_number": "201-916-3023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 10TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191147",
            "telephone_number": "212-523-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1111 Amsterdam Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100251716",
            "country_code": "US",
            "telephone_number": "212-523-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GHASSIBI",
        "first_name": "MARK",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-14",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "311158",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "NY",
            "license": "311158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.