Mark Fagelman, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

102803 Issued in NY

Practice address

11 Medical Park Dr
Suite 101
Pomona, NY 10970-3559

Phone

(845) 354-5800

Fax

(845) 354-5966

NPI assigned

Jun 14, 2006

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Mark Fagelman, M.D., P.C.

  • Ambulatory Surgical Clinic/Center
  • Pomona, NY
  • NPI 1306093364
  NPD (past) Authorized official

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1497798896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 MEDICAL PARK DR",
            "address_2": "SUITE 101",
            "city": "POMONA",
            "state": "NY",
            "postal_code": "109703559",
            "telephone_number": "845-354-5800",
            "fax_number": "845-354-5966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 MEDICAL PARK DR",
            "address_2": "SUITE 101",
            "city": "POMONA",
            "state": "NY",
            "postal_code": "109703559",
            "telephone_number": "845-354-5800",
            "fax_number": "845-354-5966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGELMAN",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "102803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00178047",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sandra Ettinger, LCSW
• Express Pediatrics
• Eyemagination Optical Corp
• Joan Hassel Facelle, M.D.
• Elliot Fagelman, M.D.
• Faithful Eye Center LLC
• Margaret Elizabeth Falvey, RPH
• Family Medicine Associates, PLLC
• Howard C Farewell, DC
• Silvia Farkas, LCSW

• Urology Physician in Pomona, NY
• Providers in Pomona, NY by specialty
• Urology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.