Mark Alan Herbrich, P.T., M.A.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

015532-1 Issued in NY

Practice address

1999 Marcus Ave
Suite M15
Lake Success, NY 11042-1013

Phone

(516) 488-8808

Fax

(516) 488-8818

NPI assigned

May 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Agewell Physical Therapy and Wellness, P.C.Group PAC ID 6507830361, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Agewell Physical Therapy and Wellness, P.C.

  • Physical Therapist
  • Lake Success, NY
  • NPI 1861485070
  Medicare reassignment Care Compare group NPD Authorized official
• Lake Success Physical Therapy P.C.

  • Clinical Electrophysiology Physical Therapist
  • New Hyde Park, NY
  • NPI 1336604222
  Medicare reassignment NPD
• Samuel Field Ym&Ywha

  • Adult Mental Health Clinic/Center
  • Little Neck, NY
  • NPI 1205862950
  NPD (past)

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212105600000",
    "number": "1619922952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "198 BRYANT AVE",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110011466",
            "telephone_number": "516-488-8808",
            "fax_number": "516-488-8818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1999 MARCUS AVE",
            "address_2": "SUITE M15",
            "city": "LAKE SUCCESS",
            "state": "NY",
            "postal_code": "110421013",
            "telephone_number": "516-488-8808",
            "fax_number": "516-488-8818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERBRICH",
        "first_name": "MARK",
        "middle_name": "ALAN",
        "credential": "P.T., M.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2008-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "015532-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bin Gu
• Alyson Gutman, MD
• Brian Hainline, MD
• Brukti Harper, MA CCC SLP
• Louis R Heisler, MD
• Jonathan Herman, M.D.
• Jim N Hilepo, MD
• Maxine Hines, FNP
• David M Hoenig, MD
• Kristin Marisa Hord, D.O.

• Physical Therapist in Lake Success, NY
• Providers in Lake Success, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.