Organization Active NPI

Physicians of University Hospital, PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Staten Island, NY
National Provider Identifier
1417901323
Registry record updated Dec 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
PHYSICIANS OF UNIVERSITY HOSPITAL, PC
Practice address
375 Seguine Ave
2ND FL.
Staten Island, NY 10309-3932
Phone
(718) 226-6789
Fax
(718) 226-6224
NPI assigned
May 22, 2006
Last updated
Dec 3, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2025

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

Authorized official

Name
Dr. Mark Jarrett, MD
Title
Director
Phone
(516) 465-3214

Specialties & licenses 13

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
Psychologist 103T00000X
Clinical Social Worker 1041C0700X
Internal Medicine Physician 207R00000X
Geriatric Medicine (Internal Medicine) Physician 207RG0300X Primary
Pediatric Endocrinology Physician 2080P0205X
Plastic Surgery Physician 208200000X
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X
Psychiatry Physician 2084P0800X
Child & Adolescent Psychiatry Physician 2084P0804X
Geriatric Psychiatry Physician 2084P0805X
Radiation Oncology Physician 2085R0001X

Addresses

Primary practice location

375 Seguine Ave
2ND FL.
Staten Island, NY 10309-3932

Mailing address

1 Edgewater St
6TH FL. Payer Relations Dept.
Staten Island, NY 10305-4900
Phone (718) 226-1008

Other practice location 1

584 Forest Ave
Staten Island, NY 10310-2512
Phone (718) 273-0553

Other practice location 2

1776 Richmond Rd
Staten Island, NY 10306-2578
Phone (718) 668-6963

Other identifiers 1

IdentifierTypeStateIssuer
02808139MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080204000002 NY Part B Supplier - Clinic/Group Practice 5890877542 Receives reassigned benefits from 580 practitioners
3 other NPIs on this enrollment
Practice locations: Staten Island, NY; Brooklyn, NY; Bay Shore, NY; New Hyde Park, NY; New York, NY

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations (25 of 45)

1185 Town Centre Dr
Ste 125
Eagan, MN 55123
Phone (651) 454-7224

555 Summit Ave
Jersey City, NJ 07306

33 Overlook Rd
Ste 208
Summit, NJ 07901
Phone (908) 522-5794

348 Albany Ave
Brooklyn, NY 11213
Phone (718) 221-1123

369 93rd St
Brooklyn, NY 11209
Phone (212) 434-3420

5724 New Utrecht Ave
Brooklyn, NY 11219
Phone (718) 436-0100

705 86th St
Ste M4
Brooklyn, NY 11228
Phone (347) 245-7745

705 86th St
Ste M5
Brooklyn, NY 11228
Phone (718) 745-2906

8622 Bay Pkwy
Ste 2D
Brooklyn, NY 11214
Phone (718) 372-8318

130 E 77th St
Fl 8
New York, NY 10075
Phone (212) 434-2150

1 Edgewater St
Fl 1
Staten Island, NY 10305
Phone (718) 226-4127

101 Tyrellan Ave
#4
Staten Island, NY 10309

11 Ralph Pl
Ste 213
Staten Island, NY 10304
Phone (718) 556-9400

1110 South Ave
Ste 306
Staten Island, NY 10314
Phone (718) 370-7100

1145 Targee St
Staten Island, NY 10304
Phone (718) 979-2310

1200 South Ave
Ste 106B
Staten Island, NY 10314

242 Mason Ave
Staten Island, NY 10305
Phone (718) 226-1458

242 Mason Ave
Fl 2
Staten Island, NY 10305
Phone (718) 226-6377

242 Mason Ave
Fl 6
Staten Island, NY 10305

242 Mason Ave
Ste 1
Staten Island, NY 10305
Phone (718) 226-6262

242 Mason Ave
Ste 2
Staten Island, NY 10305
Phone (718) 226-2279

242 Mason Ave
Ste 5
Staten Island, NY 10305
Phone (718) 226-6283

256 Mason Ave
#B
Staten Island, NY 10305
Phone (718) 226-9175

256 Mason Ave
Bldg 9
Staten Island, NY 10305

256 Mason Ave
Bldg A
Staten Island, NY 10305

Practitioners & affiliated clinicians

Practitioners 632

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 632

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764720000000",
    "number": "1417901323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EDGEWATER ST",
            "address_2": "6TH FL. PAYER RELATIONS DEPT.",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103054900",
            "telephone_number": "718-226-1008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 SEGUINE AVE",
            "address_2": "2ND FL.",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103093932",
            "telephone_number": "718-226-6789",
            "fax_number": "718-226-6224"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "584 Forest Ave",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103102512",
            "country_code": "US",
            "telephone_number": "718-273-0553",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1776 Richmond Rd",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103062578",
            "country_code": "US",
            "telephone_number": "718-668-6963",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PHYSICIANS OF UNIVERSITY HOSPITAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-22",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A",
        "authorized_official_last_name": "JARRETT",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "516-465-3214",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02808139",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.