Individual provider Active NPI

Mark Small, MS RPA-C

  • Surgical Physician Assistant
  • New York, NY
National Provider Identifier
1982770814
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
011650 Issued in NY
Practice address
423 East 23Rd St
New York, NY 10010-5011
Phone
(212) 951-3394
Fax
(212) 951-6825
NPI assigned
Nov 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 011650 NY Primary

Addresses

Primary practice location

423 East 23Rd St
New York, NY 10010-5011

Mailing address

869 East 38TH St
Brooklyn, NY 11210-3537
Phone (347) 750-5247

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MD2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170327002258 NY Practitioner - Physician Assistant 9931321643 Reassigns benefits to 1 organization
I20220407000330 MD Practitioner - Physician Assistant 9931321643 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

1406 Crain S Hwy 106
Glen Burnie, MD 21061-4086
Phone (410) 768-6440

9000 Franklin Square Dr
Baltimore, MD 21237-3901
Phone (443) 777-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince Feb 7, 2024 Accepting new patients
Medstar Medical Group II LLC CurrentSince Feb 7, 2024 Accepting new patients
Johns Hopkins University CurrentSince Feb 10, 2022 Accepting new patients
Johns Hopkins University CurrentSince Feb 10, 2022 Accepting new patients

Locations

4940 Eastern Ave
Baltimore, MD 21224

29955 Three Notch Rd
Ste 100
Charlotte Hall, MD 20622
Phone (301) 290-5300

1406 Crain Hwy S
Glen Burnie, MD 21061
Phone (410) 768-6440

6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704

Interoperability endpoints

  • Direct secure messaging: msmall981999@direct.hopkinsmedicine.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982770814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "869 EAST 38TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112103537",
            "telephone_number": "347-750-5247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "423 EAST 23RD ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100105011",
            "telephone_number": "212-951-3394",
            "fax_number": "212-951-6825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALL",
        "first_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "MS RPA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "011650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.