MARK SMITH (NPI# 1093885485) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093885485 |
| Entity Type | Individual |
| Full Name | MARK SMITH |
| Credential | MD |
| Practice Address |
4802 10th Ave Brooklyn NY 11219-2916 |
| Mailing Address |
Gpo Box 29580 New York NY 10087-9580 |
| Practice Telephone | 7182838773 |
| Practice Fax Number | 7182838796 |
| Mailing Telephone | 7182838773 |
| Mailing Fax Number | 7182838796 |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2009-03-11 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
145831 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00755197 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871025668 | Mark Robert Smith | Physical Therapist | 11448 Princessa Ln, Jacksonville, FL 32218-4054 | 2017-03-30 |
| 1982148565 | Mark Smith Jr. | Pharmacist | 2850 Venice Rd Sw, Apt 3303, Birmingham, AL 35211-6203 | 2016-12-15 |
| 1396124558 | Mark Andrew Smith | Physical Therapist | 125 S Mcdaniel Dr, Auburn, CA 95603-5742 | 2015-05-21 |
| 1760875181 | Mark Smith | Case Manager/Care Coordinator | 4028 Knollton Rd, Indianapolis, IN 46228-3332 | 2015-03-09 |
| 1366833154 | Mark James Smith | Pharmacist | 2627 Oneida St, Utica, NY 13501-6332 | 2015-02-15 |
| 1568869824 | Mark Smith | Occupational Therapy Assistant | 1160 Old State Rd, New Castle, PA 16101-6417 | 2014-12-01 |
| 1992128581 | Mark Harrison Smith | Case Manager/Care Coordinator | 346 Sycamore Ridge Way, Gahanna, OH 43230-5605 | 2014-02-03 |
| 1881967263 | Mark Steven Smith | Dentist | 7685 Wolf River Cir Ste 102, Germantown, TN 38138-1749 | 2012-02-16 |
| 1225328768 | Mark W Smith | Counselor | 2619 W. 6th St, Suite C, Lawrence, KS 66049 | 2011-04-18 |
| 1053628271 | Mark Thomas Smith | Optometrist | 592 Main St N, Mc Kenzie, TN 38201-1707 | 2010-09-09 |
| Street Address |
4802 10TH AVE |
| City | BROOKLYN |
| State | NY |
| Zip Code | 11219-2916 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316943871 | Samantha Paige Jellinek | Pharmacist | 4802 10th Ave, Brooklyn, NY 11219-2844 | 2005-06-21 |
| 1730789959 | Arjun Basnet | Student in an Organized Health Care Education/Training Program | 4802 10th Ave, Brooklyn, NY 11219-2916 | 2020-10-27 |
| 1679171623 | Shehanaz Shajahan | Student in an Organized Health Care Education/Training Program | 4802 10th Ave, Brooklyn, NY 11219-2916 | 2020-10-13 |
| 1215534524 | Syed Mohammad Mazhar Uddin | Student in an Organized Health Care Education/Training Program | 4802 10th Ave, Brooklyn, NY 11219-2916 | 2020-10-08 |
| 1619581899 | Laurel Wright | Psychologist | 4802 10th Ave, Brooklyn, NY 11219-2916 | 2020-09-03 |
| 1780296749 | Rabiah Ashraf | Student in an Organized Health Care Education/Training Program | 4802 10th Ave, Brooklyn, NY 11219-2916 | 2020-08-20 |
| 1275142820 | Jenna Danae Katherine Kroeker | Student in an Organized Health Care Education/Training Program | 4802 10th Ave, Brooklyn, NY 11219-2916 | 2020-07-29 |
| 1720696347 | Jay Donald Keith | Student in an Organized Health Care Education/Training Program | 4802 10th Ave, Brooklyn, NY 11219-2916 | 2020-07-20 |
| 1003424912 | Amit Dhaliwal | Student in an Organized Health Care Education/Training Program | 4802 10th Ave, Brooklyn, NY 11219-2916 | 2020-07-16 |
| 1912515826 | Supraja Achuthanandan | Student in an Organized Health Care Education/Training Program | 4802 10th Ave, Brooklyn, NY 11219-2916 | 2020-07-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073127163 | Chava Bokchin | Registered Nurse | 6200 15th Avenue, Brooklyn, NY 11219 | 2020-09-04 |
| 1164033643 | Debbie Evadne Evans-wright | Nurse Practitioner | 979 48th Street, Brooklyn, NY 11219 | 2020-08-10 |
| 1528614559 | Jonathan Benjamin Goldstein | Specialist | Yeled Vyalda 1312 38 Street, Brooklyn, NY 11219 | 2019-08-15 |
| 1235782301 | Vanessa Walton | Social Worker | 4012 New Utrecht Avenue, Apt 1, Brooklyn, NY 11219 | 2019-07-18 |
| 1083184618 | Sandra Murray | Licensed Practical Nurse | 6321 New Utrecht Avenue Second Floor, Brooklyn, NY 11219 | 2018-11-27 |
| 1023588746 | Wanipa Muwowo-nwade | Physician Assistant | 4802 10th Ave Rm 301, Brooklyn, NY 11219 | 2018-11-26 |
| 1366919896 | Evelin Ponce | Licensed Practical Nurse | 6321 New Utrecht Avenue, Second Floor, Brooklyn, NY 11219 | 2018-11-02 |
| 1083180301 | Yefim Simkhayev | Occupational Therapist | 1317 52nd St, Brooklyn, NY 11219 | 2018-10-15 |
| 1598240186 | F & D Pharmacy Inc | Pharmacy | 5504 -13 Ave, Brooklyn, NY 11219 | 2018-09-28 |
| 1245737469 | Yekaterina Joltikov | Student in an Organized Health Care Education/Training Program | Miamonides Medical Center, 4802 10th Ave, Brooklyn, NY 11219 | 2018-04-13 |
| Find all providers in zip 11219 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154316230 | Peter Eliot Gordon | Emergency Medicine | 218 Baltic St, Brooklyn, NY 11201-6620 | 2005-09-15 |
| 1477115251 | Wyckoff Heights Medical Center | Emergency Medicine | 374 Stockholm St, Brooklyn, NY 11237-4006 | 2019-07-02 |
| 1831552405 | Wells Brambl | Emergency Medicine | 4802 10th Ave, Brooklyn, NY 11219-2916 | 2016-04-01 |
| 1992116701 | Ag Urgent Care, P.C. | Emergency Medicine | 1349 Broadway, 1st Floor, Brooklyn, NY 11221-3618 | 2014-05-14 |
| 1629323522 | D'artagnan Francois Hinds | Emergency Medicine | 506 6th St, Brooklyn, NY 11215-3609 | 2012-07-17 |
| 1093003501 | Samuel Ayala | Emergency Medicine | 506 6th St, Methodist Hospital Emergency Department, Brooklyn, NY 11215-3609 | 2011-07-18 |
| 1821314022 | Emergency Providers of Imc | Emergency Medicine | 1545 Atlantic Ave, Brooklyn, NY 11213-1122 | 2010-04-13 |
| 1386804318 | Markus Little | Emergency Medicine | 451 Clarkson Ave, Emergency Department, Brooklyn, NY 11203-2057 | 2008-06-12 |
| 1689871527 | Fiona Elise Barriac | Emergency Medicine | 4802 10th Ave, Brooklyn, NY 11219-2916 | 2007-07-02 |
| 1336344035 | Aisha Cupid | Emergency Medicine | 800 Poly Pl, Brooklyn, NY 11209-7104 | 2007-06-20 |
| Find all providers in BROOKLYN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.