Individual provider Active NPI

Mark L Horowitz, M.D.

  • Pediatrics Physician
  • Warwick, NY
National Provider Identifier
1477649853
Registry record updated Jun 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
135749-1 Issued in NY
Practice address
10 Ronald Reagan Blvd
Warwick, NY 10990-4104
Phone
(845) 986-2058
Fax
(845) 986-7669
NPI assigned
Oct 5, 2006
Last updated
Jun 17, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 135749-1 NY Primary
Pediatrics Physician 208000000X 25MA06649400 NJ

Addresses

Primary practice location

10 Ronald Reagan Blvd
Warwick, NY 10990-4104

Mailing address

10 Ronald Reagan Blvd
Warwick, NY 10990-4104
Phone (845) 986-2058

Other identifiers 2

IdentifierTypeStateIssuer
0283908MedicaidNJ
00513617MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA06649400NJMDPediatrics Physician
135749-1NYMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245196800000",
    "number": "1477649853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 RONALD REAGAN BLVD",
            "city": "WARWICK",
            "state": "NY",
            "postal_code": "109904104",
            "telephone_number": "845-986-2058",
            "fax_number": "845-986-7669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 RONALD REAGAN BLVD",
            "city": "WARWICK",
            "state": "NY",
            "postal_code": "109904104",
            "telephone_number": "845-986-2058",
            "fax_number": "845-986-7669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOROWITZ",
        "first_name": "MARK",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2009-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "135749-1",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA06649400",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0283908",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00513617",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.