Individual provider Active NPI

Mark Christopher Pillitteri, DO

  • Obstetrics & Gynecology Physician
  • Deer Park, NY
National Provider Identifier
1679677082
Registry record updated Feb 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
199269 Issued in NY
Practice address
2017 Deer Park Ave
Deer Park, NY 11729-2727
Phone
(631) 242-7444
Fax
(631) 242-3810
NPI assigned
Sep 8, 2006
Last updated
Feb 19, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2009

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 199269 NY Primary
Gynecology Physician 207VG0400X 199269 NY
Obstetrics Physician 207VX0000X 199269 NY

Addresses

Primary practice location

2017 Deer Park Ave
Deer Park, NY 11729-2727

Mailing address

2017 Deer Park Ave
Deer Park, NY 11729-2727
Phone (631) 242-7444

Other identifiers 1

IdentifierTypeStateIssuer
01792378MedicaidNY

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101105000509 NY Practitioner - Obstetrics/Gynecology 4284828062 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
R Franklin University of Med & Sci/Chicago Medical School, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CHS Physician Partners PCGroup PAC ID 7618955667, 739 clinicians

Practice addresses (Care Compare)

1000 Montauk Hwy
West Islip, NY 11795-4927
Phone (631) 376-3000

1000 N Village Ave
Rockville Center, NY 11570-1000

2017 Deer Park Ave
Deer Park, NY 11729-2727
Phone (631) 242-7444

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
199269NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Medical Services, P.C. CurrentSince Jan 1, 2015 Accepting new patients
CHS Physician Partners, P.C CurrentSince Dec 1, 2023 Accepting new patients
CHS Physician Partners, PC Current Accepting new patients
Good Samaritan Hospital Medical Center Current Accepting new patients
Good Samaritan Hospital Medical CurrentSince May 13, 2017 Accepting new patients
Sun River Health Inc Current Accepting new patients
Sun River Health Inc. CurrentSince Sep 2, 2014 Accepting new patients
CHS Physician Partners, PC CurrentSince Dec 1, 2023 Accepting new patients
Good Samaritan Hospital Medical Center Past Accepting new patients

Locations

3360 Route 343
Amenia, NY 12501
Phone (845) 373-9006

2017 Deer Park Ave
Deer Park, NY 11729
Phone (631) 242-7444

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

100 Port Washington Blvd
Ste G3
Roslyn, NY 11576
Phone (516) 627-4800

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

1556 Straight Path
Wyandanch, NY 11798
Phone (516) 214-8020

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: mpillitteri39280@direct-chsli.net

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1157673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235001600000",
    "number": "1679677082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2017 DEER PARK AVE",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117292727",
            "telephone_number": "631-242-7444",
            "fax_number": "631-242-3810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2017 DEER PARK AVE",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117292727",
            "telephone_number": "631-242-7444",
            "fax_number": "631-242-3810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PILLITTERI",
        "first_name": "MARK",
        "middle_name": "CHRISTOPHER",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-08",
        "last_updated": "2009-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "199269",
            "primary": true
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NY",
            "license": "199269",
            "primary": false
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "NY",
            "license": "199269",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01792378",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Deer Park, NY

Sources for this page

Verify at the official NPI Registry.