Organization Active NPI

Mark D Epstein M D P C

  • Specialist
  • Hauppauge, NY
National Provider Identifier
1457609372
Registry record updated Feb 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
195372 Issued in NY
Legal business name
MARK D EPSTEIN M D P C
Practice address
200 Motor Pkwy Ste B-12
Hauppauge, NY 11788-5113
Phone
(631) 689-1100
Fax
(631) 689-1153
NPI assigned
Aug 27, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2021

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

Authorized official

Name
Dr. Mark D Epstein, MDNPI 1255393567
Title
Presudebt
Phone
(631) 689-1100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 195372 NY Primary

Addresses

Primary practice location

200 Motor Pkwy Ste B-12
Hauppauge, NY 11788-5113

Mailing address

200 Motor Pkwy Ste B-12
Hauppauge, NY 11788-5113
Phone (631) 689-1100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120831000261 NY Part B Supplier - Clinic/Group Practice 2163679838 Receives reassigned benefits from 1 practitioner
Practice locations: Hauppauge, NY

National Provider Directory

National Provider Directory

Locations

200 Motor Pkwy
Ste B12
Hauppauge, NY 11788
Phone (631) 689-1100

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1346025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612828800000",
    "number": "1457609372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MOTOR PKWY STE B-12",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117885113",
            "telephone_number": "631-689-1100",
            "fax_number": "631-689-1153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MOTOR PKWY STE B-12",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117885113",
            "telephone_number": "631-689-1100",
            "fax_number": "631-689-1153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK D EPSTEIN M D P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-27",
        "last_updated": "2021-02-09",
        "certification_date": "2021-01-14",
        "status": "A",
        "authorized_official_last_name": "EPSTEIN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESUDEBT",
        "authorized_official_telephone_number": "631-689-1100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "195372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hauppauge, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2021; 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.