Bonnie Marks, PSY.D.

Primary specialty

Rehabilitation PsychologistTaxonomy code 103TR0400X

License

019577-1 Issued in NY

Practice address

411 E 53Rd St Apt 15a
New York, NY 10022-5111

Phone

(646) 872-8238

NPI assigned

Feb 9, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• State of Connecticut

  • Psychiatric Hospital
  • Bridgeport, CT
  • NPI 1720013360
  Medicare reassignment

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

{
    "created_epoch": "1581206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581206400000",
    "number": "1427680370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 E 53RD ST APT 15A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100225111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 E 53RD ST APT 15A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100225111",
            "telephone_number": "646-872-8238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKS",
        "first_name": "BONNIE",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-09",
        "last_updated": "2020-02-09",
        "certification_date": "2020-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "NY",
            "license": "019577-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY STATE LICENSE",
            "identifier": "019577-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adam Ross Marks, MD-PHD
• Alexa Marks
• Andrea Meryl Marks, MD
• Andrew R Marks, MD
• Beth Marks
• Braden Marks, LMSW
• Charles Matthew Marks, D.D.S.
• Corie Lee Marks, RCP RRT
• Daniel Roy Marks
• David Jeffrey Marks, PH.D.

• Rehabilitation Psychologist in New York, NY
• Providers in New York, NY by specialty
• Rehabilitation Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2020; 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.

Verify at the official NPI Registry.