Marc Mahoney Beuttler

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

70675 Issued in CT

Practice address

281 1St Ave
New York, NY 10003-2925

Phone

(805) 901-3317

NPI assigned

Apr 19, 2018

Last updated

Aug 2, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

Specialty

Dermatology

Education

Louisiana State University School of Medicine in New Orleans, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Modern Dermatology PCGroup PAC ID 7618228164, 6 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Modern Dermatology PC

  • Dermatology Physician
  • Westport, CT
  • NPI 1497258719
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1524096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1376030866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1032 POST RD E",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068805369",
            "telephone_number": "203-635-0770",
            "fax_number": "203-635-0771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "281 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100032925",
            "telephone_number": "805-901-3317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEUTTLER",
        "first_name": "MARC",
        "middle_name": "MAHONEY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-19",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CT",
            "license": "70675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prarthana Beuria, MD
• Lucila Iliana Beuses, MD
• Heidi Beutler
• Kyle Beuttenmuller
• Megan D'Alessio Beuttenmuller, BSN, RN
• Frederick Anthony Bevelaqua, M.D.
• Christine Beverin
• Beverley D. Zabriskie
• Cordia L Beverley, M.D.
• Beverly W. Hurd MD PC

• Dermatology Physician in New York, NY
• Providers in New York, NY by specialty
• Dermatology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.