Individual provider Active NPI

Mark Preston, MD

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • Waterbury, CT
National Provider Identifier
1902992274
Registry record updated Nov 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianTaxonomy code 207VF0040X
License
040237 Issued in CT
Practice address
60 Westwood Ave
Ste 200
Waterbury, CT 06708
Phone
(203) 574-5501
Fax
(203) 596-0912
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 040237 CT
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician 207VF0040X 040237 CT Primary

Addresses

Primary practice location

60 Westwood Ave
Ste 200
Waterbury, CT 06708

Mailing address

60 Westwood Ave
Ste 200
Waterbury, CT 06708
Phone (203) 574-5501

Other identifiers 1

IdentifierTypeStateIssuer
001402370MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20160924000027 NJ Practitioner - Obstetrics/Gynecology 9739232273 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Columbia University College of Physicians and Surgeons, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Barnabas Health Medical Group PCGroup PAC ID 9537316955, 1,027 clinicians

Practice addresses (Care Compare)

166 Lyons Ave
Newark, NJ 07112-2016

201 Lyons Ave
Newark, NJ 07112-2027

225 Williamson St
Elizabeth, NJ 07202-3625
Phone (888) 724-7123

94 Old Short Hills Rd
Livingston, NJ 07039-5672

Hospital & facility affiliations

  • Newark Beth Israel Medical Center Hospital, Newark, NJ, CCN 310002
  • Trinitas Regional Medical Center Hospital, Elizabeth, NJ, CCN 310027

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
94.87
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
98.51 of 100Reported as apm
Quality
84.27
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
040237CTMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rwjbh Observation Associates LLC CurrentSince Oct 28, 2023 Accepting new patients
Trinitas Physicians Practice, LLC CurrentSince Sep 1, 2016 Accepting new patients
University Physician Associates of New Jersey Inc CurrentSince Aug 1, 2021 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Nov 29, 2023 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Nov 29, 2023 Accepting new patients
University Physician Associates of New Jersey Inc CurrentSince Aug 1, 2021 Accepting new patients

Locations

240 Williamson St
Ste 305
Elizabeth, NJ 07202
Phone (908) 351-7500

240 Williamson St
Ste 401
Elizabeth, NJ 07202
Phone (908) 282-0500

65 Jefferson Ave
Ste 2
Elizabeth, NJ 07201
Phone (908) 677-5040

355 Grand St
Jersey City, NJ 07302
Phone (201) 915-2224

475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

235 Millburn Ave
Ste 101
Millburn, NJ 07041
Phone (973) 376-8034

140 Bergen St
Newark, NJ 07103
Phone (973) 972-0320

110 Rehill Ave
Somerville, NJ 08876
Phone (908) 429-5833

1 Hamilton Health Pl
Trenton, NJ 08690
Phone (609) 584-6763

Interoperability endpoints

  • Direct secure messaging: mpreston260554@epicdirect.rwjbh.org
  • Direct secure messaging: mark.preston.1@3830.direct.athenahealth.com

Organizations & group practices 6

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 5

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385424000000",
    "number": "1902992274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 WESTWOOD AVE",
            "address_2": "STE 200",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "06708",
            "telephone_number": "203-574-5501",
            "fax_number": "203-596-0912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 WESTWOOD AVE",
            "address_2": "STE 200",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "06708",
            "telephone_number": "203-574-5501",
            "fax_number": "203-596-0912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESTON",
        "first_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2013-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "CT",
            "license": "040237",
            "primary": false
        },
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "CT",
            "license": "040237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001402370",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.