Mark Medical Care, PLLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

2147731 Issued in NY

Legal business name

MARK MEDICAL CARE, PLLC

Practice address

2103 Deer Park Ave Ste 200
Deer Park, NY 11729-1317

Phone

(631) 574-2060

NPI assigned

Apr 4, 2013

Last updated

Oct 19, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ron Mark, MDNPI 1013917301

Title

President

Phone

(576) 376-5562

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ron Mark, M.D.

  • Diagnostic Radiology Physician
  • Deer Park, NY
  • NPI 1013917301
  Medicare reassignment Care Compare group NPD Authorized official
• Jeffrey Gunzenhauser, MD

  • Vascular & Interventional Radiology Physician
  • Brooklyn, NY
  • NPI 1205829181
  Medicare reassignment Care Compare group NPD
• Michael Steven Shapiro, MD

  • Vascular Surgery Physician
  • Brooklyn, NY
  • NPI 1184888968
  Medicare reassignment Care Compare group NPD
• Mauricio Szuchmacher, M.D.

  • Vascular Surgery Physician
  • Port Jefferson Station, NY
  • NPI 1336300896
  Medicare reassignment Care Compare group NPD
• Harry H Tsou, MD

  • Vascular & Interventional Radiology Physician
  • Long Island City, NY
  • NPI 1598792632
  Medicare reassignment Care Compare group NPD
• Esteban A Benavides

  • Medical Physician Assistant
  • Woodhaven, NY
  • NPI 1255687570
  Medicare reassignment Care Compare group
• Sarah Colon, PA-C

  • Physician Assistant
  • Maspeth, NY
  • NPI 1215782867
  Medicare reassignment Care Compare group
• Marianela Fernandez

  • Physician Assistant
  • Jamaica, NY
  • NPI 1063924272
  Medicare reassignment Care Compare group
• Cindy Medrano, PA

  • Physician Assistant
  • Freeport, NY
  • NPI 1184130213
  NPD (past)
• Fernando Tan Jr., P.T.

  • Specialist
  • Baldwin, NY
  • NPI 1871512426
  NPD (past)
• Patricia Ting Tan, M.D.

  • Pediatric Rehabilitation Medicine Physician
  • Baldwin, NY
  • NPI 1821086737
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1365033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603065600000",
    "number": "1962745398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 ANNETTE WAY",
            "city": "JERICHO",
            "state": "NY",
            "postal_code": "117532836",
            "telephone_number": "516-376-5562",
            "fax_number": "949-863-8548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2103 DEER PARK AVE STE 200",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117291317",
            "telephone_number": "631-574-2060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "385 W Sunrise Hwy",
            "address_purpose": "LOCATION",
            "city": "Freeport",
            "state": "NY",
            "postal_code": "115203120",
            "country_code": "US",
            "telephone_number": "516-321-4747",
            "fax_number": "877-673-8535",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6405 Woodside Ave",
            "address_purpose": "LOCATION",
            "city": "Woodside",
            "state": "NY",
            "postal_code": "113773654",
            "country_code": "US",
            "telephone_number": "877-376-2751",
            "fax_number": "877-673-8535",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5503 Myrtle Ave",
            "address_purpose": "LOCATION",
            "city": "Ridgewood",
            "state": "NY",
            "postal_code": "113853550",
            "country_code": "US",
            "telephone_number": "631-574-2060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MARK MEDICAL CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-04",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A",
        "authorized_official_last_name": "MARK",
        "authorized_official_first_name": "RON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "576-376-5562",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "2147731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mancini Physical Therapy, PC
• John Mancini, MSPT
• Jesslynn Mannino, NP
• Valerie Nicole Marino
• Allison Marinos
• Ron Mark, M.D.
• Jacquelyn Martin
• Masoom H. Qadeer, M.D., P.C.
• Seena Merin Mathew
• Teresa Mattutat

• Specialist in Deer Park, NY
• Providers in Deer Park, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.