Individual provider Active NPI

Marc Wilkenfeld, M.D.

  • Preventive Medicine/Occupational Environmental Medicine Physician
  • New York, NY
National Provider Identifier
1508906744
Registry record updated Sep 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X
License
167655-1 Issued in NY
Practice address
453 FDR Dr
Suite 2002
New York, NY 10002-5952
Phone
(212) 614-9115
NPI assigned
Feb 7, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X 167655-1 NY Primary

Addresses

Primary practice location

453 FDR Dr
Suite 2002
New York, NY 10002-5952

Mailing address

453 FDR Dr
Suite 2002
New York, NY 10002-5952
Phone (212) 614-9115

Other practice location 1

1300 Franklin Ave
Garden City, NY 11530-1886
Phone (516) 663-8890

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mwilenfeld238919@nyumc.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070831000417 NY Practitioner - Preventive Medicine 4981797289 Reassigns benefits to 1 organization
Practice locations: Garden City, NY

Care Compare profile

Medicare Care Compare

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
167655-1NYMDPreventive Medicine/Occupational Environmental Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Oct 1, 2018 Accepting new patients
New York University CurrentSince Oct 1, 2018 Accepting new patients

Locations

1300 Franklin Ave
Garden City, NY 11530
Phone (516) 535-1201

1300 Franklin Ave
Ste ML6
Garden City, NY 11530
Phone (516) 353-1900

1300 Franklin Ave
Ste UL4A
Garden City, NY 11530
Phone (516) 663-3907

340 W Park Ave
Long Beach, NY 11561
Phone (516) 431-5064

120 Mineola Blvd
Ste 600
Mineola, NY 11501
Phone (516) 663-4525

Interoperability endpoints

  • Direct secure messaging: mwilenfeld238919@nyumc.direct-ci.com

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": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1508906744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "453 FDR DR",
            "address_2": "SUITE 2002",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100025952",
            "telephone_number": "212-614-9115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "453 FDR DR",
            "address_2": "SUITE 2002",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100025952",
            "telephone_number": "212-614-9115"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 Franklin Ave",
            "address_purpose": "LOCATION",
            "city": "Garden City",
            "state": "NY",
            "postal_code": "115301886",
            "country_code": "US",
            "telephone_number": "516-663-8890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILKENFELD",
        "first_name": "MARC",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "NY",
            "license": "167655-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mwilenfeld238919@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "1300 Franklin Ave",
            "city": "Garden City",
            "state": "NY",
            "country_code": "US",
            "postal_code": "115301886",
            "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.