Individual provider Active NPI

Mark Tamarin

  • Physician Assistant
  • New Rochelle, NY
National Provider Identifier
1760194492
Registry record updated Jun 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
73 Ward Dr
New Rochelle, NY 10804-1918
Phone
(914) 819-8955
NPI assigned
Dec 14, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NY Primary

Addresses

Primary practice location

73 Ward Dr
New Rochelle, NY 10804-1918

Mailing address

73 Ward Dr
New Rochelle, NY 10804-1918
Phone (914) 819-8955

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240923003905 NY Practitioner - Physician Assistant 9133660731 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
032331NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
New York City Health and Hospitals Corporation CurrentSince Sep 1, 2024 Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Sep 1, 2024 Accepting new patients
New York City Health and Hospitals Corporation Past Accepting new patients

Locations

3424 Kossuth Ave
Bronx, NY 10467
Phone (718) 519-3972

7901 Broadway
Flushing, NY 11373
Phone (718) 334-2156

7901 Broadway
#D127
Flushing, NY 11373

8268 164th St
Jamaica, NY 11432
Phone (718) 883-2929

50 Water St
Fl 3
New York, NY 10004

Networks

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

Interoperability endpoints

  • Direct secure messaging: mtamarin3521772@nychhc.direct-ci.com

Organizations & group practices 4

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": "1670976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719014400000",
    "number": "1760194492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73 WARD DR",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108041918",
            "telephone_number": "914-819-8955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 WARD DR",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108041918",
            "telephone_number": "914-819-8955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAMARIN",
        "first_name": "MARK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-12-14",
        "last_updated": "2024-06-22",
        "certification_date": "2024-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Rochelle, NY

Sources for this page

Verify at the official NPI Registry.