Individual provider Active NPI

Mark R Liss, MD

  • Specialist
  • New Rochelle, NY
National Provider Identifier
1902906142
Registry record updated Dec 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
137170 Issued in NY
Practice address
140 Lockwood Ave
Suite 318
New Rochelle, NY 10801-4915
Phone
(914) 633-0888
Fax
(914) 633-0951
NPI assigned
Sep 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 137170 NY Primary

Addresses

Primary practice location

140 Lockwood Ave
Suite 318
New Rochelle, NY 10801-4915

Mailing address

140 Lockwood Ave
Suite 318
New Rochelle, NY 10801-4915
Phone (914) 633-0888

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
I20110228000876 NY Practitioner - Gastroenterology 2163603895 Reassigns benefits to 1 organization
Practice locations: New Rochelle, NY

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Icahn School of Medicine at Mount Sinai, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Montefiore New Rochelle HospitalGroup PAC ID 0345474706, 62 clinicians

Practice addresses (Care Compare)

16 Guion PL
New Rochelle, NY 10801-5502
Phone (914) 365-4065

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy72
Upper gastrointestinal (GI) endoscopy for acid reflux59

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore New Rochelle Hospital CurrentSince Nov 6, 2013 Accepting new patients

Locations

140 Lockwood Ave
Ste 318
New Rochelle, NY 10801
Phone (914) 633-0888

16 Guion Pl
New Rochelle, NY 10801
Phone (914) 365-3680

Networks

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

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 1

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": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292198400000",
    "number": "1902906142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 LOCKWOOD AVE",
            "address_2": "SUITE 318",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108014915",
            "telephone_number": "914-633-0888",
            "fax_number": "914-633-0951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 LOCKWOOD AVE",
            "address_2": "SUITE 318",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108014915",
            "telephone_number": "914-633-0888",
            "fax_number": "914-633-0951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISS",
        "first_name": "MARK",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2010-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "137170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Rochelle, NY

Sources for this page

Verify at the official NPI Registry.