NPIMap

Organization Active NPI

Marcus Avenue OB/GYN, PC

  • Obstetrics & Gynecology Physician
  • New Hyde Park, NY
National Provider Identifier
1679322259
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
MARCUS AVENUE OB/GYN, PC
Practice address
1 Hollow LN Ste 315
New Hyde Park, NY 11042-1215
Phone
(516) 437-4300
Fax
(516) 437-2033
NPI assigned
May 15, 2024
Last updated
May 15, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2024

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

Authorized official

Name
Christine J Duncan, MDNPI 1306842497
Title
Administrator
Phone
(516) 437-4300

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
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

1 Hollow LN Ste 315
New Hyde Park, NY 11042-1215

Mailing address

1 Hollow LN Ste 315
New Hyde Park, NY 11042-1215
Phone (516) 437-4300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240719002193 NY Part B Supplier - Clinic/Group Practice 9739625302 Receives reassigned benefits from 9 practitioners
Practice locations: Forest Hills, NY; Huntington, NY; Manhasset, NY; New Hyde Park, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1715731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715731200000",
    "number": "1679322259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOLLOW LN STE 315",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421215",
            "telephone_number": "516-437-4300",
            "fax_number": "516-437-2033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOLLOW LN STE 315",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421215",
            "telephone_number": "516-437-4300",
            "fax_number": "516-437-2033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARCUS AVENUE OB/GYN, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-15",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A",
        "authorized_official_last_name": "DUNCAN",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "516-437-4300",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; 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.