Individual provider Active NPI

Luciano E De Marco, M.D.

  • Internal Medicine Physician
  • Valhalla, NY
National Provider Identifier
1902940968
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
145754 Issued in NY
Practice address
137 Columbus Avenue
Valhalla, NY 10595-1732
Phone
(914) 761-9117
Fax
(914) 761-7731
NPI assigned
Feb 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 145754 NY Primary

Addresses

Primary practice location

137 Columbus Avenue
Valhalla, NY 10595-1732

Mailing address

137 Columbus Avenue
Valhalla, NY 10595-1732
Phone (914) 761-9117

Other identifiers 6

IdentifierTypeStateIssuer
WP754OtherNYOXFORD
LD030D1010OtherNYEMPIRE BLUE CROSS BLUE SHIELD
0068360OtherNYGHI
30D101OtherNYMEDICARE ID- TYPE UNSPECIFIED
3C0527OtherNYHEALTH NET
110014726OtherGAPALMETTO GBA

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
I20110328000889 NY Practitioner - Internal Medicine 6103009121 Practice locations: Valhalla, NY

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

137 Columbus Ave
Valhalla, NY 10595-1732
Phone (914) 761-9117

Hospital & facility affiliations

National Provider Directory

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

Hospital & facility affiliations 2

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": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213747200000",
    "number": "1902940968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 COLUMBUS AVENUE",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "105951732",
            "telephone_number": "914-761-9117",
            "fax_number": "914-761-7731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 COLUMBUS AVENUE",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "105951732",
            "telephone_number": "914-761-9117",
            "fax_number": "914-761-7731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE MARCO",
        "first_name": "LUCIANO",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2008-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "145754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "WP754",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BLUE CROSS BLUE SHIELD",
            "identifier": "LD030D1010",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0068360",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID- TYPE UNSPECIFIED",
            "identifier": "30D101",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "3C0527",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "110014726",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valhalla, NY

Sources for this page

Verify at the official NPI Registry.