NPIMap

Individual provider Active NPI

Mark H Genovesi, M.D.

  • Surgery Physician
  • Brooklyn, NY
National Provider Identifier
1578582292
Registry record updated Aug 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
181571 Issued in NY
Practice address
8318 4TH Ave
Brooklyn, NY 11209-4413
Phone
(718) 748-0500
Fax
(718) 748-5539
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 181571 NY Primary

Addresses

Primary practice location

8318 4TH Ave
Brooklyn, NY 11209-4413

Mailing address

1439 Roosevelt Ave
Pelham, NY 10803-3607
Phone (914) 235-4004

Other identifiers 1

IdentifierTypeStateIssuer
209923853OtherNYTAX ID

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mgenovesi132643@nyumc.direct-ci.com NYU Langone Hospitals

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051026001147 NY Practitioner - Cardiac SurgeryPractitioner - Thoracic Surgery 2163449422 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac Surgery
Education
State University of New York Downstate Medical Center, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1500 Route 112
Suite 8B
Port Jefferson Station, NY 11776-8053
Phone (917) 715-3192

37 Northern Blvd
Unit 15
Greenvale, NY 11548-4001

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
181571NYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
NYU Langone Hospitals Current Accepting new patients
NYU Langone Hospitals CurrentSince Jan 11, 2017 Accepting new patients
Long Island Lung Surgery PC Surgery CurrentSince Dec 1, 2020 Accepting new patients
NYU Langone Hospitals CurrentSince Jan 11, 2017 Accepting new patients
LMC Physician Services, PC Surgery Past Accepting new patients
Good Samaritan Hospital Medical Center Past Accepting new patients
University Physicians of Brooklyn, Inc. Surgery Past Accepting new patients

Locations

4295 Hempstead Tpke
Bethpage, NY 11714
Phone (516) 520-2250

150 55th St
Brooklyn, NY 11220
Phone (718) 630-7185

150 55th St
Rm 3618
Brooklyn, NY 11220
Phone (718) 630-7477

8714 5th Ave
Brooklyn, NY 11209
Phone (718) 630-8600

37 Northern Blvd
Unit 15
Greenvale, NY 11548
Phone (917) 715-3192

301 E 17th St
New York, NY 10003
Phone (212) 460-0125

1500 Route 112
Ste 8B
Port Jefferson Station, NY 11776
Phone (917) 715-3192

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Organizations & group practices 7

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.

Hospital & facility affiliations 5

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628208000000",
    "number": "1578582292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1439 ROOSEVELT AVE",
            "city": "PELHAM",
            "state": "NY",
            "postal_code": "108033607",
            "telephone_number": "914-235-4004",
            "fax_number": "718-748-5539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8318 4TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112094413",
            "telephone_number": "718-748-0500",
            "fax_number": "718-748-5539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENOVESI",
        "first_name": "MARK",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "181571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "209923853",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mgenovesi132643@nyumc.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "NYU Langone Hospitals",
            "address_1": "150 55th St",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112202559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.