Individual provider Active NPI

Mark Harris Haltrecht, D.O.

  • Family Medicine Physician
  • Merrick, NY
National Provider Identifier
1366510620
Registry record updated Jan 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
242484 Issued in NY
Practice address
1825 Merrick Rd
Merrick, NY 11566-4559
Phone
(516) 867-5132
Fax
(516) 867-5519
NPI assigned
Dec 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 242484 NY Primary
Diagnostic Radiology Physician 2085R0202X 242484 NY

Addresses

Primary practice location

1825 Merrick Rd
Merrick, NY 11566-4559

Mailing address

1825 Merrick Rd
Merrick, NY 11566-4559
Phone (516) 867-5132

Other identifiers 2

IdentifierTypeStateIssuer
0258GLOtherNYGHI MEDICARE
02891752MedicaidNY

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
I20070815000452 NY Practitioner - Family Practice 4789776113 Reassigns benefits to 1 organization
Practice locations: Merrick, NY

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2004
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Doctors Medical Office PLLCGroup PAC ID 4880813229, 2 clinicians

Practice addresses (Care Compare)

1825 Merrick Rd
Merrick, NY 11566-4559
Phone (516) 867-5132

Hospital & facility affiliations

  • Mt. Sinai at Home Home health agency, Westbury, NY, CCN 337246
  • Catholic Home Care Home health agency, Farmingdale, NY, CCN 337147

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
242484NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Mark Haltrecht PLLC Diagnostic Radiology Current Accepting new patients
Doctors Medical Office PLLC Family Medicine CurrentSince Mar 10, 2014 Accepting new patients

Locations

1825 Merrick Rd
Merrick, NY 11566
Phone (516) 377-2738

389 Merrick Ave
North Merrick, NY 11566
Phone (516) 247-6449

Networks

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

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.

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": "1165017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767744000000",
    "number": "1366510620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 MERRICK RD",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115664559",
            "telephone_number": "516-867-5132",
            "fax_number": "516-867-5519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 MERRICK RD",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115664559",
            "telephone_number": "516-867-5132",
            "fax_number": "516-867-5519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALTRECHT",
        "first_name": "MARK",
        "middle_name": "HARRIS",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-02",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "242484",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "242484",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI MEDICARE",
            "identifier": "0258GL",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02891752",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrick, NY

Sources for this page

Verify at the official NPI Registry.