Individual provider Active NPI

Marrick L Kukin, M.D.

  • Cardiovascular Disease Physician
  • New York, NY
National Provider Identifier
1609869551
Registry record updated May 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
25MA10015100 Issued in NJ
Practice address
158 E 84TH St
New York, NY 10028-2005
Phone
(212) 535-6340
NPI assigned
Aug 25, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA10015100 NJ
Advanced Heart Failure and Transplant Cardiology Physician 207RA0001X 155618 NY
Cardiovascular Disease Physician 207RC0000X 155168 NY
Cardiovascular Disease Physician 207RC0000X 25MA10015100 NJ Primary

Addresses

Primary practice location

158 E 84TH St
New York, NY 10028-2005

Mailing address

130 E 77TH St
New York, NY 10075-1851
Phone (212) 535-6340

Other identifiers 1

IdentifierTypeStateIssuer
01105820MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040527001282 NY Practitioner - Cardiovascular Disease (Cardiology) 7810989142 Reassigns benefits to 3 organizations
I20221005000714 NJ Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 7810989142 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
University of Pittsburgh School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Barnabas Health Medical Group PCGroup PAC ID 9537316955, 1,027 clinicians

Practice addresses (Care Compare)

375 Mount Pleasant Ave
West Orange, NJ 07052-2750
Phone (973) 731-9442

Merit-based Incentive Payment System (MIPS)

Final score
98.51 of 100Reported as apm
Quality
84.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA10015100NJMDCardiovascular Disease Physician
155168NYMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Icahn School of Medicine at Mount Sinai Cardiovascular Disease CurrentSince May 1, 2017 Accepting new patients
North Shore-Lij Medical PC Internal Medicine CurrentSince Oct 3, 2018 Accepting new patients
Icahn School of Medicine at Mount Sinai Cardiovascular Disease CurrentSince Jan 1, 2016 Accepting new patients
Icahn School of Medicine at Mount Sinai Internal Medicine CurrentSince Jan 1, 2016 Accepting new patients
Barnabas Health Medical Group PC Internal Medicine CurrentSince Jun 23, 2022 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Jun 23, 2022 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince May 1, 2017 Accepting new patients
Mount Sinai School of Medicine Cardiovascular Disease Past Accepting new patients

Locations

475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

379 Campus Dr
Fl 4
Somerset, NJ 08873
Phone (732) 507-6545

780 Route 37 W
Ste 310
Toms River, NJ 08755
Phone (732) 240-0599

375 Mount Pleasant Ave
West Orange, NJ 07052
Phone (973) 322-6900

100 E 77th St
New York, NY 10075
Phone (212) 434-2606

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

1111 Amsterdam Ave
New York, NY 10025
Phone (212) 523-2309

10 Union Sq E
New York, NY 10003
Phone (212) 253-6800

425 W 59th St
New York, NY 10019
Phone (212) 376-3180

158 E 84th St
New York, NY 10028
Phone (212) 535-6340

425 W 59th St
Ste 9C
New York, NY 10019
Phone (212) 492-5550

130 E 77th St
New York, NY 10075
Phone (212) 434-2606

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Interoperability endpoints

  • Direct secure messaging: marrickkukin@nslijmedgr.allscriptsdirect.net

Organizations & group practices 9

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": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714521600000",
    "number": "1609869551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 E 77TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100751851",
            "telephone_number": "212-535-6340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 E 84TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100282005",
            "telephone_number": "212-535-6340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUKIN",
        "first_name": "MARRICK",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-25",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA10015100",
            "primary": false
        },
        {
            "code": "207RA0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Advanced Heart Failure and Transplant Cardiology",
            "state": "NY",
            "license": "155618",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "155168",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NJ",
            "license": "25MA10015100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01105820",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.