Individual provider Active NPI

Marc David Waldman, M.D.

  • Psychiatry Physician
  • Cross River, NY
National Provider Identifier
1790881043
Registry record updated Dec 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
183880 Issued in NY
Practice address
892 Route 35
Cross River, NY 10518-1141
Phone
(914) 763-6119
NPI assigned
Sep 15, 2006
Last updated
Dec 19, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2011

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 183880 NY Primary

Addresses

Primary practice location

892 Route 35
Cross River, NY 10518-1141

Mailing address

P.O. Box 612
Cross River, NY 10518-0612
Phone (914) 763-6119

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
I20120504000378 NY Practitioner - Psychiatry 0042472243 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
State University of New York Downstate Medical Center, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

892 Route 35
Cross River, NY 10518-1141
Phone (914) 763-6119

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
183880NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Johanna Lubbe Physical Therapy PC CurrentSince Feb 10, 2021 Accepting new patients
Marc Waldman, M.D., P.C. Psychiatry CurrentSince Dec 19, 2011 Accepting new patients

Locations

892 Route 35
Cross River, NY 10518
Phone (914) 763-0458

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324252800000",
    "number": "1790881043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 612",
            "city": "CROSS RIVER",
            "state": "NY",
            "postal_code": "105180612",
            "telephone_number": "914-763-6119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "892 ROUTE 35",
            "city": "CROSS RIVER",
            "state": "NY",
            "postal_code": "105181141",
            "telephone_number": "914-763-6119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDMAN",
        "first_name": "MARC",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2011-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "183880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cross River, NY

Sources for this page

Verify at the official NPI Registry.