Active NPI
Luciano E De Marco, M.D.
- Internal Medicine Physician
- Valhalla, NY
National Provider Identifier
1902940968
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 145754
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| WP754 | Other | NY | OXFORD |
| LD030D1010 | Other | NY | EMPIRE BLUE CROSS BLUE SHIELD |
| 0068360 | Other | NY | GHI |
| 30D101 | Other | NY | MEDICARE ID- TYPE UNSPECIFIED |
| 3C0527 | Other | NY | HEALTH NET |
| 110014726 | Other | GA | PALMETTO 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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.
-
- Home Health Agency
- Brooklyn, NY
- NPI 1770513145
-
dba White Plains Hospital Center
- General Acute Care Hospital
- White Plains, NY
- NPI 1447255153
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; 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.