Individual provider Active NPI

Mark Waynik, MD

  • Psychiatry Physician
  • Fairfield, CT
National Provider Identifier
1588738256
Registry record updated Oct 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
024277 Issued in CT
Practice address
52 Beach Rd
Suite 104
Fairfield, CT 06824
Phone
(203) 254-2000
Fax
(203) 255-3126
NPI assigned
Nov 17, 2006
Last updated
Oct 18, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 024277 CT Primary

Addresses

Primary practice location

52 Beach Rd
Suite 104
Fairfield, CT 06824

Mailing address

52 Beach Rd
Suite 104
Fairfield, CT 06824
Phone (203) 254-2000

Other identifiers 1

IdentifierTypeStateIssuer
1242775MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20090820000040 CT Practitioner - Psychiatry 7012007297 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Washington University School of Medicine, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cyril Waynik MD PCGroup PAC ID 8921198193, 9 clinicians

Practice addresses (Care Compare)

52 Beach Rd
Suite 104
Fairfield, CT 06824-6017
Phone (203) 254-2000

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
024277CTMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Health, Inc. Psychiatry CurrentSince Jan 1, 2012 Accepting new patients
Cyril Waynik MD PC Psychiatry CurrentSince Dec 20, 1988 Accepting new patients

Locations

2800 Main St
Bridgeport, CT 06606
Phone (203) 386-0366

1055 Post Rd
Fairfield, CT 06824
Phone (203) 254-1055

52 Beach Rd
Ste 104
Fairfield, CT 06824
Phone (203) 254-2000

2 Trap Falls Rd
Ste 120
Shelton, CT 06484
Phone (203) 641-6090

160 Hawley Ln
Ste 200
Trumbull, CT 06611
Phone (203) 380-4022

Organizations & group practices 3

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": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350518400000",
    "number": "1588738256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 BEACH RD",
            "address_2": "SUITE 104",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "06824",
            "telephone_number": "203-254-2000",
            "fax_number": "203-255-3126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 BEACH RD",
            "address_2": "SUITE 104",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "06824",
            "telephone_number": "203-254-2000",
            "fax_number": "203-255-3126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAYNIK",
        "first_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2012-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "024277",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1242775",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CT

Sources for this page

Verify at the official NPI Registry.