Individual provider Active NPI

Kenneth Mroczek, M.D.

  • Orthopaedic Surgery Physician
  • New York, NY
National Provider Identifier
1407842818
Registry record updated Mar 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
210377 Issued in NY
Practice address
530 First Avenue
5 D
New York, NY 10016
Phone
(212) 263-3491
NPI assigned
Sep 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 210377 NY Primary

Addresses

Primary practice location

530 First Avenue
5 D
New York, NY 10016

Mailing address

530 First Avenue
5 D
New York, NY 10016
Phone (212) 263-3491

Other identifiers 1

IdentifierTypeStateIssuer
02168707MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kmroczek9287@nyumc.direct-ci.com

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
I20110426000628 NY Practitioner - Orthopedic Surgery 0143405795 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

100 E 77TH St
New York, NY 10075-1850
Phone (212) 434-6980

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

Merit-based Incentive Payment System (MIPS)

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
210377NYMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC Orthopaedic Surgery CurrentSince Nov 1, 2024 Accepting new patients
New York University Orthopaedic Surgery CurrentSince Feb 2, 2011 Accepting new patients

Locations

525 W 36th St
Fl 7
New York, NY 10018
Phone (646) 429-0016

210 E 64th St
Fl 4
New York, NY 10065
Phone (212) 434-3365

5 Columbus Cir
Fl 10
New York, NY 10019
Phone (212) 265-2828

7 7th Ave
Fl 2
New York, NY 10011
Phone (212) 889-8575

530 1st Ave
Ste 5D
New York, NY 10016
Phone (212) 263-3491

100 E 77th St
Fl 3
New York, NY 10075
Phone (212) 434-2900

530 1st Ave
#5D
New York, NY 10016
Phone (212) 263-3491

30 7th Ave
New York, NY 10011
Phone (646) 665-6000

300 Community Dr
Plandome, NY 11030

658 White Plains Rd
Tarrytown, NY 10591
Phone (888) 636-7840

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Networks

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

Interoperability endpoints

  • Direct secure messaging: kmroczek70434@northwell.direct-ci.com
  • Direct secure messaging: kmroczek9287@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.

Hospital & facility affiliations 1

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": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615161600000",
    "number": "1407842818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 FIRST AVENUE",
            "address_2": "5 D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10016",
            "telephone_number": "212-263-3491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 FIRST AVENUE",
            "address_2": "5 D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10016",
            "telephone_number": "212-263-3491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MROCZEK",
        "first_name": "KENNETH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-21",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "210377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02168707",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmroczek9287@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "530 First Avenue",
            "address_2": "5 D",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "10016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.