Individual provider Active NPI

Jeffrey C Marc, MD

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1962578229
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
144388 Issued in NY
Practice address
1711 Sheepshead Bay Rd
Lover Level
Brooklyn, NY 11235-3651
Phone
(718) 332-7717
Fax
(718) 615-9590
NPI assigned
Nov 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

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 144388 NY Primary

Addresses

Primary practice location

1711 Sheepshead Bay Rd
Lover Level
Brooklyn, NY 11235-3651

Mailing address

1711 Sheepshead Bay Rd Lower Level
Brooklyn, NY 11235-3651
Phone (718) 332-7717

Other identifiers 1

IdentifierTypeStateIssuer
00855789MedicaidNY

Other names 1

  • Jeffrey Marc Chwatuk Former name

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
I20050803000968 NY Practitioner - Internal Medicine 1557399102 Practice locations: Brooklyn, NY; Woodmere, NY

Care Compare profile

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

Practice addresses (Care Compare)

1711 Sheepshead Bay Rd
Brooklyn, NY 11235-3651
Phone (718) 332-7717

Hospital & facility affiliations

  • Girling Health Care of New York Home health agency, Brooklyn, NY, CCN 337243

Merit-based Incentive Payment System (MIPS)

Final score
96.6 of 100Reported as apm
Quality
79.86
Promoting interoperability
88.89
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
144388NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Body Wellness Chiropractic, P.C PastSince Jul 16, 2023 Accepting new patients
Traube Marush & Plawes M D P C Internal Medicine Past Accepting new patients
Park Slope Medical Service PC Past Accepting new patients

Networks

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

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/26654/brand/3/csg/1/fhir/r4

Organizations & group practices 3

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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1962578229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 SHEEPSHEAD BAY RD LOWER LEVEL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112353651",
            "telephone_number": "718-332-7717",
            "fax_number": "718-615-9590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 SHEEPSHEAD BAY RD",
            "address_2": "LOVER LEVEL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112353651",
            "telephone_number": "718-332-7717",
            "fax_number": "718-615-9590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARC",
        "first_name": "JEFFREY",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "144388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00855789",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEFFREY",
            "last_name": "CHWATUK",
            "middle_name": "MARC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.