NPIMap

Individual provider Active NPI

Mary Randall Parker, M.D.

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1790781789
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
211803 Issued in NY
Practice address
635 Madison Ave
FL 8
New York, NY 10022-1009
Phone
(212) 857-4655
Fax
(212) 752-3390
NPI assigned
Jun 23, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 211803 NY Primary

Addresses

Primary practice location

635 Madison Ave
FL 8
New York, NY 10022-1009

Mailing address

635 Madison Ave
FL 8
New York, NY 10022-1009
Phone (212) 857-4655

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
I20101209000512 NY Practitioner - Internal Medicine 0345437810 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Tufts University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Madison Physicians, LLPGroup PAC ID 0345616371, 6 clinicians

Practice addresses (Care Compare)

575 Madison Ave
Suite 1501
New York, NY 10022-2511
Phone (212) 857-4522

Hospital & facility affiliations

  • Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393
  • Valley Hospital Hospital, Paramus, NJ, CCN 310012
  • NYU Langone Hospitals Hospital, New York, NY, CCN 330214
  • Rusk Rehabilitation Inpatient rehabilitation facility, New York, NY, CCN 33T214

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
211803NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Madison Physicians, LLP Internal Medicine CurrentSince Dec 1, 2022 Accepting new patients

Locations

635 Madison Ave
Fl 7
New York, NY 10022
Phone (212) 317-4500

575 Madison Ave
Ste 1501
New York, NY 10022
Phone (212) 857-4522

635 Madison Ave
Fl 8
New York, NY 10022
Phone (212) 857-4590

Interoperability endpoints

  • Direct secure messaging: mary.parker.1@26416.direct.athenahealth.com

Organizations & group practices 1

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.

Hospital & facility affiliations 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790781789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 MADISON AVE",
            "address_2": "FL 8",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100221009",
            "telephone_number": "212-857-4655",
            "fax_number": "212-752-3390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 MADISON AVE",
            "address_2": "FL 8",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100221009",
            "telephone_number": "212-857-4655",
            "fax_number": "212-752-3390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "MARY",
        "middle_name": "RANDALL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "211803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.