Mark Schaefer, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

035972 Issued in NY

Practice address

6053 Fresh Pond Rd
Maspeth, NY 11378-3541

Phone

(718) 417-5383

NPI assigned

Oct 19, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: mschaefer14079@direct.medisys.org

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639251002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6053 FRESH POND RD",
            "city": "MASPETH",
            "state": "NY",
            "postal_code": "113783541",
            "telephone_number": "718-417-5383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6053 FRESH POND RD",
            "city": "MASPETH",
            "state": "NY",
            "postal_code": "113783541",
            "telephone_number": "718-417-5383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAEFER",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "035972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hermilia Sardelis
• Joseph S Savitt, M.D.
• Andrew Sayedarous
• Natalia Sayedarous
• Ann Kimiko Schaefer, D.D.S.
• Julia Kay Schafer
• Maryam Schnieber
• Stuart Scott
• Teresa Catherine Sharkey Eustace
• Sharp Vision Optical Inc.

• General Practice Dentistry in Maspeth, NY
• Providers in Maspeth, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.