Individual provider Active NPI

Mark Richard Lukowitsky, PH.D.

  • Clinical Psychologist
  • Albany, NY
National Provider Identifier
1659620953
Registry record updated Aug 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
019739-1 Issued in NY
Practice address
25 Hackett Blvd
Department of Psychiatry
Albany, NY 12208-3462
Phone
(518) 262-5511
NPI assigned
Aug 31, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 019739-1 NY Primary

Addresses

Primary practice location

25 Hackett Blvd
Department of Psychiatry
Albany, NY 12208-3462

Mailing address

159 S Allen St
Albany, NY 12208-2126
Phone (814) 574-7477

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121024000049 NY Practitioner - Clinical Psychologist 4183874332 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Pennsylvania State University College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Albany Medical CollegeGroup PAC ID 1759293111, 1,054 clinicians

Practice addresses (Care Compare)

25 Hackett Blvd
Albany, NY 12208-3462
Phone (518) 264-0900

Merit-based Incentive Payment System (MIPS)

Final score
87.78 of 100Reported as group
Quality
77.53
Promoting interoperability
100
Improvement activities
40
Cost
76.35

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
019739-1NYMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Albany Medical College CurrentSince May 1, 2019 Accepting new patients
Albany Medical College CurrentSince Sep 13, 2012 Accepting new patients
Albany Medical College CurrentSince Sep 13, 2012 Accepting new patients

Locations

25 Hackett Blvd
Albany, NY 12208
Phone (518) 262-1200

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

Organizations & group practices 3

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": "1346371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346371200000",
    "number": "1659620953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 S ALLEN ST",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122082126",
            "telephone_number": "814-574-7477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 HACKETT BLVD",
            "address_2": "DEPARTMENT OF PSYCHIATRY",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083462",
            "telephone_number": "518-262-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUKOWITSKY",
        "first_name": "MARK",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-31",
        "last_updated": "2012-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "019739-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.