Individual provider Active NPI

Dustin H Marks, MD

  • Dermatology Physician
  • New York, NY
National Provider Identifier
1497379184
Registry record updated Apr 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
328767 Issued in NY
Practice address
116 E 68TH St Apt 1C
New York, NY 10065-5995
Phone
(212) 570-9595
Fax
(646) 569-9881
NPI assigned
May 29, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X PENDING PA
Internal Medicine Physician 207R00000X MT220256 PA
Dermatology Physician 207N00000X 328767 NY Primary

Addresses

Primary practice location

116 E 68TH St Apt 1C
New York, NY 10065-5995

Mailing address

450 Broadway St FL C2
Redwood City, CA 94063-3132
Phone (650) 723-6316

Other practice location 1

100 Livingston St # 3L
Brooklyn, NY 11201-5127
Phone (347) 797-5005

Other practice location 2

45 Northern Blvd
Greenvale, NY 11548-1346
Phone (516) 506-7546

Electronic endpoints 2

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE)
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20241030000974 NY Practitioner - Dermatology 2668894833 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
99.15 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
328767NYMDDermatology Physician
MT220256PAMDInternal Medicine Physician
PENDINGPAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mandel-Wilentz Dermatology PLLC Dermatology Current Accepting new patients

Locations

45 Northern Blvd
Greenvale, NY 11548
Phone (516) 506-7546

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1590710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776297600000",
    "number": "1497379184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 BROADWAY ST FL C2",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940633132",
            "telephone_number": "650-723-6316",
            "fax_number": "646-569-9881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 E 68TH ST APT 1C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100655995",
            "telephone_number": "212-570-9595",
            "fax_number": "646-569-9881"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Livingston St # 3L",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112015127",
            "country_code": "US",
            "telephone_number": "347-797-5005",
            "fax_number": "720-306-7224",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "45 Northern Blvd",
            "address_purpose": "LOCATION",
            "city": "Greenvale",
            "state": "NY",
            "postal_code": "115481346",
            "country_code": "US",
            "telephone_number": "516-506-7546",
            "fax_number": "516-259-2499",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARKS",
        "first_name": "DUSTIN",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-29",
        "last_updated": "2026-04-16",
        "certification_date": "2026-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "PENDING",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT220256",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "328767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1400 Veterans Blvd # 1F",
            "city": "Redwood City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "940632612",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1400 Veterans Blvd # 1F",
            "city": "Redwood City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "940632612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.