Mark Gventer, DPM, P.C.

Primary specialty

Foot Surgery PodiatristTaxonomy code 213ES0131X

License

N002605 Issued in NY

Practice address

2965 Ocean Pkwy
Ste 403
Brooklyn, NY 11235-8014

Phone

(718) 265-1140

Fax

(718) 648-2211

NPI assigned

Jun 16, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292198400000",
    "number": "1821093840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2965 OCEAN PKWY",
            "address_2": "STE 403",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112358014",
            "telephone_number": "718-265-1140",
            "fax_number": "718-648-2211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2965 OCEAN PKWY",
            "address_2": "STE 403",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112358014",
            "telephone_number": "718-265-1140",
            "fax_number": "718-648-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GVENTER",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "DPM, P.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2010-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NY",
            "license": "N002605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00415018",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2210604",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P618996",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0085809",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1343406-005",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "4C7517",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "63679",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "A400024901",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Josephine S Gwira, RN
• Rodney Alexander Gwyn, LCSW

• Foot Surgery Podiatrist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Foot Surgery Podiatrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.