Mark Walter Kozicky, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

280931 Issued in NY

Practice address

967 N Broadway
St. Johns Riverside Hospital
Yonkers, NY 10701

Phone

(914) 964-4444

NPI assigned

Jun 20, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Internal Medicine

Education

New York Medical College, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SJR Medical, PCGroup PAC ID 5991608440, 43 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St John's Riverside Hospital Hospital, Yonkers, NY, CCN 330208

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/23390/brand/1/csg/1/fhir/r4
• Direct secure messaging: mkozicky@stjohnsmedicalpc.directmedgenehr.com

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.

• SJR Medical, PC

  • Multi-Specialty Clinic/Center
  • Yonkers, NY
  • NPI 1366468936

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Symphony Medical PC

  • Hospitalist Physician
  • Dobbs Ferry, NY
  • NPI 1659787653
  Medicare reassignment NPD
• Symphony Medical PC

  • Orthopaedic Surgery Physician
  • Dobbs Ferry, NY
  • NPI 1023600327
  NPD

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

• St. John's Riverside Hospital

  • General Acute Care Hospital
  • Yonkers, NY
  • NPI 1578526695
  Care Compare affiliation

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

{
    "created_epoch": "1340150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532044800000",
    "number": "1891058228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "967 N BROADWAY",
            "address_2": "ST. JOHNS RIVERSIDE HOSPITAL OFFICE OF GRADUATE MED ED",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "10701",
            "telephone_number": "914-964-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "967 N BROADWAY",
            "address_2": "ST. JOHNS RIVERSIDE HOSPITAL",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "10701",
            "telephone_number": "914-964-4444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "128 Ashford Ave",
            "address_purpose": "LOCATION",
            "city": "Dobbs Ferry",
            "state": "NY",
            "postal_code": "105221924",
            "country_code": "US",
            "telephone_number": "914-693-6500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOZICKY",
        "first_name": "MARK",
        "middle_name": "WALTER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-20",
        "last_updated": "2018-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "280931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suresh Oommen Koshy, DDS
• Harshitha Kota
• Frank Kou, BCBA
• Johnny G Kovoor
• Michael William Kowgios
• Orest John Kozicky, MD
• Cynthia Kramer, LCSW
• Deborah Kramer, MSN, CPNP, CFNP
• Sarjoni V Kraus, LPN
• Alison Kriegel

• Internal Medicine Physician in Yonkers, NY
• Providers in Yonkers, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.