Individual provider Active NPI

Mark Geurts

  • Student in an Organized Health Care Education/Training Program
  • Brooklyn, NY
National Provider Identifier
1568997013
Registry record updated Apr 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
663 Degraw St Apt 2
Brooklyn, NY 11217-3111
Phone
(917) 373-9359
NPI assigned
Apr 21, 2017
Last updated
Apr 21, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

663 Degraw St Apt 2
Brooklyn, NY 11217-3111

Mailing address

663 Degraw St Apt 2
Brooklyn, NY 11217
Phone (917) 373-9359

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
I20201217000816 NY Practitioner - Family Practice 0446598924 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
306573NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Oct 16, 2020 Accepting new patients
Montefiore Medical Center CurrentSince Oct 16, 2020 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

100 Corporate Dr
#100
Yonkers, NY 10701

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1492732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492732800000",
    "number": "1568997013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "663 DEGRAW ST APT 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11217",
            "telephone_number": "917-373-9359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "663 DEGRAW ST APT 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112173111",
            "telephone_number": "917-373-9359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEURTS",
        "first_name": "MARK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-21",
        "last_updated": "2017-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.