Active NPI
Mark Fenster
- Pediatrics Physician
- Brooklyn, NY
National Provider Identifier
1376566620
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 172975-1
- Practice address
- 2601 Ocean Pkwy
Brooklyn, NY 11235-7745 - Phone
- (718) 616-4408
- Fax
- (718) 616-4105
- NPI assigned
- Jul 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 172975-1 | NY | Primary |
Addresses
Primary practice location
2601 Ocean Pkwy
Brooklyn, NY 11235-7745
Mailing address
3 Heather LN
Lawrence, NY 11559-1833
Phone (516) 239-2677
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01086915 | Medicaid | NY |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 172975-1 | NY | MD | Pediatrics Physician |
Practice roles (5 of 9)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physician Affiliate Group of New York PC | Current | Accepting new patients | |
| Coney Island Medical Practice Plan, P.C. | Current | Accepting new patients | |
| University Group Medical Associates, P.C | Pediatrics | Past | Accepting new patients |
| New York City Health and Hospitals Corporation | Past | Accepting new patients | |
| Parkway Pediatric Associates | Past | Accepting new patients |
Locations
2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354
506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
Organizations & group practices 5
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.
-
- General Practice Physician
- Brooklyn, NY
- NPI 1386951762
-
- Registered Dietitian
- New York, NY
- NPI 1013375526
-
- General Acute Care Hospital
- Brooklyn, NY
- NPI 1124032982
-
- Specialist
- Brooklyn, NY
- NPI 1598954356
-
- Diagnostic Radiology Physician
- Brooklyn, NY
- NPI 1285683102
Pediatrics
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376566620",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 HEATHER LN",
"city": "LAWRENCE",
"state": "NY",
"postal_code": "115591833",
"telephone_number": "516-239-2677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2601 OCEAN PKWY",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112357745",
"telephone_number": "718-616-4408",
"fax_number": "718-616-4105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FENSTER",
"first_name": "MARK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "172975-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01086915",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Brooklyn, 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.