Individual provider Active NPI

Mark Richard Wax

  • Diagnostic Radiology Physician
  • Huntington Station, NY
National Provider Identifier
1487622114
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
182178 Issued in NY
Practice address
180 E Pulaski Rd
Huntington Station, NY 11746-1915
Phone
(631) 425-2175
NPI assigned
Mar 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 182178 NY Primary

Addresses

Primary practice location

180 E Pulaski Rd
Huntington Station, NY 11746-1915

Mailing address

180 E Pulaski Rd
Huntington Station, NY 11746-1915

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mwax105017@nyumc.direct-ci.com Other NYU Langone

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20031211000046 NY Practitioner - Diagnostic Radiology 0244136158 Reassigns benefits to 2 organizations
I20251010003696 FL Practitioner - Diagnostic Radiology 0244136158 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
State University of New York Downstate Medical Center, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

1300 Ave P
Brooklyn, NY 11229-1106
Phone (718) 376-1004

13303 Jamaica Ave
Jamaica, NY 11418-2618
Phone (718) 206-6923

159 E 53Rd St
New York, NY 10022-4602
Phone (646) 754-3300

160 E 34TH St
New York, NY 10016-4744
Phone (212) 263-7300

16244 S Military TRL
560 NYU Langone Cardiology Delray Bea
Delray Beach, FL 33484-6532
Phone (561) 495-7787

180 E Pulaski Rd
Huntington Station, NY 11746-1915
Phone (516) 747-8900

22414 Merrick Blvd
Laurelton, NY 11413-2023
Phone (718) 949-6433

2318 31St St
Suite 200
Astoria, NY 11105-2765
Phone (718) 777-7742

530 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

550 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

560 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

6915 Austin St
Forest Hills, NY 11375-4255
Phone (718) 544-5100

74 Kent St
Brooklyn, NY 11222-1517
Phone (516) 365-4949

9785 Queens Blvd
Rego Park, NY 11374-3319
Phone (718) 261-9100

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
182178NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Jun 1, 2015 Accepting new patients
New York University CurrentSince Jun 1, 2015 Accepting new patients
St Catherine of Siena Medical Center Past Accepting new patients
Radiology Consulting of Long Island PLLC Diagnostic Radiology Past Accepting new patients

Locations

16244 S Military Trl
Ste 560
Delray Beach, FL 33484
Phone (561) 495-7787

180 Pulaski Rd
Huntington Station, NY 11746
Phone (631) 425-2121

13303 Jamaica Ave
#13292
Richmond Hill, NY 11418
Phone (718) 291-3276

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

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

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1487622114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 E PULASKI RD",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117461915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 E PULASKI RD",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117461915",
            "telephone_number": "631-425-2175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAX",
        "first_name": "MARK",
        "middle_name": "RICHARD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "182178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mwax105017@nyumc.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "NYU Langone",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Other",
            "address_1": "180 E Pulaski Rd",
            "city": "Huntington Station",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117461915",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntington Station, NY

Sources for this page

Verify at the official NPI Registry.