NPIMap

Organization Active NPI

Mark J Coronel MD PC

  • Gastroenterology Physician
  • Riverhead, NY
National Provider Identifier
1639445869
Registry record updated Apr 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
MARK J CORONEL MD PC
Practice address
34 Commerce Ave
Riverhead, NY 11901-3118
Phone
(631) 591-3000
Fax
(631) 591-1734
NPI assigned
Apr 2, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2012

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

Authorized official

Name
Dr. Mark J. Coronel, PC OWNERNPI 1346416963
Title
Physician
Phone
(631) 591-3000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

34 Commerce Ave
Riverhead, NY 11901-3118

Mailing address

34 Commerce Ave
Riverhead, NY 11901-3118
Phone (631) 591-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120530000365 NY Part B Supplier - Clinic/Group Practice 5890958979 Receives reassigned benefits from 18 practitioners
Practice locations: Manorville, NY

National Provider Directory

National Provider Directory

Locations

383 N Sunrise Service Rd
Ste 2
Manorville, NY 11949
Phone (631) 591-3000

289 Wading Riv Rd Ste 2
Manorville, NY 11949

34 Commerce Ave
Riverhead, NY 11901
Phone (631) 591-3000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/4303/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1333324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333324800000",
    "number": "1639445869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 COMMERCE AVE",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119013118",
            "telephone_number": "631-591-3000",
            "fax_number": "631-591-1734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 COMMERCE AVE",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119013118",
            "telephone_number": "631-591-3000",
            "fax_number": "631-591-1734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK J CORONEL MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-02",
        "last_updated": "2012-04-02",
        "status": "A",
        "authorized_official_last_name": "CORONEL",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "631-591-3000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PC OWNER"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverhead, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.