MARK J. IVANICK MD – NPI #1629065198
Internal Medicine

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

MARK IVANICK is a physician located in ELMIRA, NY. NPPES has assigned the NPI number 1629065198 to MARK IVANICK on September 30, 2005. It is a Type-1 NPI, indicating this NPI number is associated with an individual. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207RP1001X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine, specializing in Pulmonary Disease

The NPI profile was previously updated about 6 years ago on Nov 25, 2020. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MARK IVANICK below.

NPI Profile for
MARK J. IVANICK

NPI Number
1629065198
Enumeration Date

(more than 20 years ago)
Entity Type
Type-1  Individual (Male)
Legal Name
MARK J. IVANICK
Credentials
MD
Primary location
600 ROE AVENUE
SUITE 4A
ELMIRA, NY 14905-1629
Phone: (607) 271-3780 Fax: (607) 271-3894
1 Other location(s):
226 W Morris St
Bath, NY 14810-1413
Phone: (607) 776-8700
Fax: (607) 776-3679
Mailing address
571 SAINT JOSEPHS BLVD FL 2
ELMIRA, NY 14901-3230
Phone: (607) 271-2050 Fax: (607) 873-1244
Sole Proprietor
No
Updated
Certification Date
Nov 25, 2020

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for MARK IVANICK

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDNY00650211
MEDICAIDPA001003160
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207RP1001X
- Internal Medicine / Pulmonary Disease (Primary)
NY NY139254-1
207RC0200X
- Internal Medicine / Critical Care Medicine
NY 139254

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.