Individual provider Active NPI

Matthew Roman Pabis, M.D.

  • Family Medicine Physician
  • New York, NY
National Provider Identifier
1376981589
Registry record updated Jan 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
285645 Issued in NY
Practice address
57 St Mark'S Place
New York, NY 10003-4318
Phone
(212) 982-3470
NPI assigned
Jun 10, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 285645 NY Primary

Addresses

Primary practice location

57 St Mark'S Place
New York, NY 10003-4318

Mailing address

201 E 69TH St
Ste 2C
New York, NY 10021-5465
Phone (212) 982-3470

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
I20170317001669 NY Practitioner - Family Practice 6204111032 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Mark'S Place Institute for Mental Health IncGroup PAC ID 4688565740, 17 clinicians

Practice addresses (Care Compare)

57 Saint Marks PL
New York, NY 10003-7902
Phone (212) 982-3470

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
285645NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mark'S Place Institute for Mental Health, Inc CurrentSince Jul 4, 2019 Accepting new patients

Locations

57 Saint Marks Pl
New York, NY 10003
Phone (212) 982-3470

Networks

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

Interoperability endpoints

  • Direct secure messaging: mpabis418309@nyumc.direct-ci.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1370822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515456000000",
    "number": "1376981589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E 69TH ST",
            "address_2": "STE 2C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100215465",
            "telephone_number": "212-982-3470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 ST MARK'S PLACE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034318",
            "telephone_number": "212-982-3470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PABIS",
        "first_name": "MATTHEW",
        "middle_name": "ROMAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-10",
        "last_updated": "2018-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "285645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.