NPIMap

Individual provider Active NPI

Mark Julian Zuckerman, MD

  • Neurology Physician
  • Smithtown, NY
National Provider Identifier
1790846244
Registry record updated May 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
171222 Issued in NY
Practice address
373 Route 111
Suite 20
Smithtown, NY 11787-4759
Phone
(631) 360-3366
Fax
(631) 360-3380
NPI assigned
Dec 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 171222 NY Primary

Addresses

Primary practice location

373 Route 111
Suite 20
Smithtown, NY 11787-4759

Mailing address

373 Route 111
Suite 20
Smithtown, NY 11787-4759
Phone (631) 360-3366

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
I20090623000653 NY Practitioner - Neurology 6002967510 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

373 Route 111 20
Smithtown, NY 11787-4759
Phone (631) 360-3366

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
23.64 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
78.79

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mark J. Zuckerman, Physician, P.C. Neurology CurrentSince Apr 29, 2009 Accepting new patients

Locations

373 Route 111
Ste 20
Smithtown, NY 11787
Phone (631) 360-3366

363 Route 111
Ste 102
Smithtown, NY 11787
Phone (631) 360-3366

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.179004

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

Hospital & facility affiliations 9

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": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305504000000",
    "number": "1790846244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "373 ROUTE 111",
            "address_2": "SUITE 20",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117874759",
            "telephone_number": "631-360-3366",
            "fax_number": "631-360-3380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "373 ROUTE 111",
            "address_2": "SUITE 20",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117874759",
            "telephone_number": "631-360-3366",
            "fax_number": "631-360-3380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUCKERMAN",
        "first_name": "MARK",
        "middle_name": "JULIAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2011-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "171222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

Verify at the official NPI Registry.