NPIMap

Individual provider Active NPI

Mark S Madis, M.D.

  • Obstetrics & Gynecology Physician
  • Goshen, NY
National Provider Identifier
1730109687
Registry record updated Jul 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
149680 Issued in NY
Practice address
30 Hatfield LN
Goshen, NY 10924-6766
Phone
(845) 291-7400
Fax
(845) 291-7049
NPI assigned
Jul 20, 2006
Last updated
Jul 14, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 149680 NY Primary

Addresses

Primary practice location

30 Hatfield LN
Goshen, NY 10924-6766

Mailing address

20 Grand St
FL 3
Warwick, NY 10990-1035
Phone (845) 294-8888

Other identifiers 1

IdentifierTypeStateIssuer
00782605MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090429000336 NY Practitioner - Obstetrics/Gynecology 6002902947 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bon Secours Charity Health System Medical Group, P.C.Group PAC ID 1658262084, 157 clinicians

Practice addresses (Care Compare)

70 Hatfield LN
Goshen, NY 10924-6734
Phone (845) 294-8888

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.73 of 100Reported as apm
Quality
87.82
Promoting interoperability
92
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Charity Health System Medical Group, P.C. Obstetrics & Gynecology CurrentSince Aug 1, 2015 Accepting new patients
The Westchester Medical Group PC Past Accepting new patients
Community OB GYN Associates Obstetrics & Gynecology Past Accepting new patients

Locations

20 Prospect Ave
Ste 516
Hackensack, NJ 07601
Phone (201) 488-8989

521 Route 515
Vernon, NJ 07462
Phone (973) 764-1883

70 Hatfield Ln
Goshen, NY 10924
Phone (845) 294-2006

70 Hatfield Ln
Ste 101
Goshen, NY 10924
Phone (845) 294-8888

20 Grand St
Fl 3
Warwick, NY 10990
Phone (845) 987-3901

Networks

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

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
St. Joseph's PlacePort Jervis, NY, CCN 335692 Skilled nursing facility Corporate Director
Adp of the SNF		 Jan 1, 2023
Aug 25, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594684800000",
    "number": "1730109687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 GRAND ST",
            "address_2": "FL 3",
            "city": "WARWICK",
            "state": "NY",
            "postal_code": "109901035",
            "telephone_number": "845-294-8888",
            "fax_number": "845-987-5979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 HATFIELD LN",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "109246766",
            "telephone_number": "845-291-7400",
            "fax_number": "845-291-7049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADIS",
        "first_name": "MARK",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2020-07-14",
        "certification_date": "2020-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "149680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00782605",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Goshen, NY

Sources for this page

Verify at the official NPI Registry.