Kenneth Andre Mark, MD is a medicare enrolled "Dermatology - Mohs-micrographic Surgery" physician in Southampton, New York. He went to State University Of Ny Upstate Medical University and graduated in 1995 and has 29 years of diverse experience with area of expertise as Dermatology. His current practice location is
365 County Road 39a, Suite 14, Southampton, New York. You can reach out to his office (for appointments etc.) via phone at
(631) 283-0002.
Kenneth Andre Mark is licensed to practice in New York (license number 204164) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1538199310.
Physician's Profile
| Full Name | Kenneth Andre Mark |
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| Gender | Male |
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| Speciality | Dermatology |
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| Experience | 29 Years |
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| Location | 365 County Road 39a, Southampton, New York |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Kenneth Andre Mark attended and graduated from State University Of Ny Upstate Medical University in 1995
NPI Data:
- NPI Number: 1538199310
- Provider Enumeration Date: 07/04/2006
- Last Update Date: 09/12/2012
Medicare PECOS Information:
- PECOS PAC ID: 0345234175
- Enrollment ID: I20040413001514
Medical Identifiers
Medical identifiers for Kenneth Andre Mark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1538199310 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207ND0101X | Dermatology - Mohs-micrographic Surgery | 204164 (New York) | Primary |
| 207N00000X | Dermatology | 204164 (New York) | Secondary |
| 207NS0135X | Dermatology - Procedural Dermatology | 204164 (New York) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kenneth Andre Mark allows following entities to bill medicare on his behalf.
| Entity Name | Kenneth Mark Md Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1992982748
PECOS PAC ID: 6608953377
Enrollment ID: O20080404000337 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kenneth Andre Mark is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Kenneth Andre Mark, MD
Po Box 175,
Water Mill, NY 11976-0175
Ph: (631) 283-0002 | Kenneth Andre Mark, MD
365 County Road 39a, Suite 14,
Southampton, NY 11968-5284
Ph: (631) 283-0002 |
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