Individual provider Active NPI

Mark A Jackson, MD

  • Anesthesiology Physician
  • Bronx, NY
National Provider Identifier
1588749972
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
213641 Issued in NY
Practice address
MMC - Dept. of Anesthesiology
111 East 210TH Street
Bronx, NY 10467
Phone
(718) 920-6369
NPI assigned
Oct 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 213641 NY Primary

Addresses

Primary practice location

MMC - Dept. of Anesthesiology
111 East 210TH Street
Bronx, NY 10467

Mailing address

42A Dickson St
Glen Cove, NY 11542-2813
Phone (718) 920-6369

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
I20070912000773 NY Practitioner - Anesthesiology 3072606649 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Albert Einstein College of Medicine of Yeshiva University, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Singular Anesthesia Services PLLCGroup PAC ID 7618284092, 72 clinicians

Practice addresses (Care Compare)

55 Palmer Ave
Bronxville, NY 10708-3403
Phone (914) 787-1000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New York Gi Center LLC CurrentSince Jul 8, 2023 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Oct 29, 2021 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Oct 29, 2021 Accepting new patients
Singular Anesthesia Services, PLLC Anesthesiology CurrentSince Nov 1, 2015 Accepting new patients
Lenox Hill Medical Anesthesiology, PLLC Past Accepting new patients

Locations

1200 Waters Pl
Ste M117
Bronx, NY 10461
Phone (718) 863-0575

3219 E Tremont Ave
Bronx, NY 10461
Phone (718) 792-7625

55 Palmer Ave
Bronxville, NY 10708
Phone (914) 787-3136

1980 Crompond Rd
Cortlandt Mnr, NY 10567
Phone (914) 734-3600

141 S Central Ave
Ste 301
Hartsdale, NY 10530
Phone (914) 713-3228

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

800A 5th Ave
Ste 504
New York, NY 10065
Phone (212) 421-1110

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

150 S Pearl St
Pearl River, NY 10965
Phone (845) 623-6141

688 White Plains Rd
Scarsdale, NY 10583
Phone (914) 337-3976

226 Westchester Ave
White Plains, NY 10604
Phone (914) 437-9910

984 N Broadway
Ste 501
Yonkers, NY 10701
Phone (914) 636-1700

2422 Central Park Ave
Yonkers, NY 10710
Phone (914) 779-2995

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • Direct secure messaging: maj9001@direct.nyp.org

Organizations & group practices 5

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": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1588749972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42A DICKSON ST",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422813",
            "telephone_number": "718-920-6369",
            "fax_number": "718-881-2245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MMC - DEPT. OF ANESTHESIOLOGY",
            "address_2": "111 EAST 210TH STREET",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10467",
            "telephone_number": "718-920-6369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "213641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.