Individual provider Active NPI

Marinelle Valdez de Los Santos Quim, MD

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Jersey City, NJ
National Provider Identifier
1013249739
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
25MA09214400 Issued in NJ
Practice address
21 McWilliams PL
Jersey City, NJ 07302-1609
Phone
(201) 706-7175
Fax
(201) 604-6553
NPI assigned
Feb 4, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25MA09214400 NJ
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 25MA09214400 NJ Primary

Addresses

Primary practice location

21 McWilliams PL
Jersey City, NJ 07302-1609

Mailing address

21 McWilliams PL
Jersey City, NJ 07302-1609
Phone (201) 706-7175

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20160405001267 NJ Practitioner - Pediatric Medicine 3072810142 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.07 of 100Reported as group
Quality
76.5
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA09214400NJMDPediatric Emergency Medicine (Pediatrics) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rwjbh Observation Associates LLC CurrentSince Nov 30, 2020 Accepting new patients
Rutgers Health-RWJ Pediatric Critical Care Pediatric Emergency Medicine CurrentSince Mar 21, 2016 Accepting new patients
Southern Bank Emergency Physicians LLC CurrentSince Oct 1, 2025 Accepting new patients
Rutgers Health-RWJ Pediatric Critical Care CurrentSince Feb 1, 2021 Accepting new patients
Rwjbh Emergency Medicine Associates, LLC CurrentSince Nov 30, 2020 Accepting new patients

Locations

225 Williamson St
Elizabeth, NJ 07202
Phone (908) 994-5204

600 River Ave
Lakewood, NJ 08701
Phone (732) 363-1900

94 Old Short Hills Rd
#C
Livingston, NJ 07039

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

254 Easton Ave
New Brunswick, NJ 08901
Phone (732) 565-5453

1 Rwj Pl
New Brunswick, NJ 08901
Phone (732) 235-7887

125 Paterson St
Ste 6140
New Brunswick, NJ 08901
Phone (732) 235-6230

110 Rehill Ave
Somerville, NJ 08876
Phone (908) 429-5833

1 Hamilton Health Pl
Trenton, NJ 08690
Phone (609) 584-6763

Interoperability endpoints

  • Direct secure messaging: marinelle.quim@pmuc.eclinicaldirectplus.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1265241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1013249739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 MCWILLIAMS PL",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073021609",
            "telephone_number": "201-706-7175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 MCWILLIAMS PL",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073021609",
            "telephone_number": "201-706-7175",
            "fax_number": "201-604-6553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUIM",
        "first_name": "MARINELLE",
        "middle_name": "VALDEZ DE LOS SANTOS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-04",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA09214400",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "NJ",
            "license": "25MA09214400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

Verify at the official NPI Registry.