Individual provider Active NPI

Mark Benjamin Gersten, MD

  • Internal Medicine Physician
  • Bayside, NY
National Provider Identifier
1972589794
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
124702 Issued in NY
Practice address
58 47 Francis Lewis Blvd
Suite 204
Bayside, NY 11364
Phone
(718) 229-6688
NPI assigned
Dec 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 124702 NY Primary

Addresses

Primary practice location

58 47 Francis Lewis Blvd
Suite 204
Bayside, NY 11364

Mailing address

260 Middle Neck Rd
Apt 3B
Great Neck, NY 11021-1158
Phone (516) 482-4174

Other identifiers 1

IdentifierTypeStateIssuer
00325484MedicaidNY

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
I20111110000120 NY Practitioner - Internal Medicine 2668645557 Practice locations: Bay Shore, NY; Bayside, NY; Bronx, NY; Jamaica, NY; Queens Village, NY

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1972589794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 MIDDLE NECK RD",
            "address_2": "APT 3B",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110211158",
            "telephone_number": "516-482-4174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 47 FRANCIS LEWIS BLVD",
            "address_2": "SUITE 204",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "11364",
            "telephone_number": "718-229-6688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERSTEN",
        "first_name": "MARK",
        "middle_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "124702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00325484",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayside, NY

Sources for this page

Verify at the official NPI Registry.