Individual provider Active NPI

Mark Mankoff

  • Psychiatry Physician
  • New York, NY
National Provider Identifier
1699781500
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
092450 Issued in NY
Practice address
1879 Madison Ave
New York, NY 10035-2709
Phone
(212) 423-4400
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 092450 NY Primary

Addresses

Primary practice location

1879 Madison Ave
New York, NY 10035-2709

Mailing address

1879 Madison Ave
New York, NY 10035-2709

Other identifiers 1

IdentifierTypeStateIssuer
00149142MedicaidNY

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
I20040416000262 NY Practitioner - Psychiatry 0244225605 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Albert Einstein College of Medicine of Yeshiva University, 1963
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Samaritan Medical CenterGroup PAC ID 8123914876, 157 clinicians

Practice addresses (Care Compare)

1575 Washington St
Watertown, NY 13601-9371
Phone (315) 779-5060

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
092450NYMDClinical Social Worker
22328NJMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Psychiatry Current Accepting new patients
Clifton-Fine Healthcare Corporation CurrentSince Mar 1, 2025 Accepting new patients
Samaritan Medical Center Current Accepting new patients
Samaritan Medical Center CurrentSince Jun 8, 2025 Accepting new patients
North General Physician Services PLLC Psychiatry PastSince Jul 1, 2006 Accepting new patients

Locations

10881 US Route 11
Adams, NY 13605
Phone (315) 232-4400

1014 Oswegatchie Trail Rd
Star Lake, NY 13690
Phone (315) 848-3351

830 Washington St
Watertown, NY 13601
Phone (315) 785-4000

1575 Washington St
Watertown, NY 13601
Phone (315) 779-5060

Interoperability endpoints

  • Direct secure messaging: markmankoff@tdh.allscriptsdirect.net

Organizations & group practices 5

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1699781500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1879 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100352709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1879 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100352709",
            "telephone_number": "212-423-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANKOFF",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "092450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00149142",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.