Individual provider Active NPI

Marinella Mabalot

  • Student in an Organized Health Care Education/Training Program
  • Lewisburg, WV
National Provider Identifier
1023684289
Registry record updated May 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
400 North Jefferson Street
Lewisburg, WV 24901
Phone
(304) 647-6529
Fax
(304) 647-1273
NPI assigned
May 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

400 North Jefferson Street
Lewisburg, WV 24901

Mailing address

400 North Jefferson Street
Lewisburg, WV 24901

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241009002725 VA Practitioner - Hospitalist 1951832328 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
West Virginia School of Osteopathic Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Physician Services IncGroup PAC ID 5092608448, 793 clinicians

Practice addresses (Care Compare)

1500 Commonwealth Ave
Williamsburg, VA 23185-5229
Phone (757) 585-2250

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Physician Services, Inc. CurrentSince Aug 1, 2024 Accepting new patients
Riverside Physician Services Inc Current Accepting new patients
Riverside Physician Services Inc CurrentSince Aug 1, 2024 Accepting new patients

Locations

858 J Clyde Morris Blvd
Newport News, VA 23601
Phone (757) 594-4343

856 J Clyde Morris Blvd
Ste A
Newport News, VA 23601
Phone (757) 316-5900

1500 Commonwealth Ave
Williamsburg, VA 23185
Phone (757) 585-2200

Interoperability endpoints

  • Direct secure messaging: mmabalot220680@direct.rivhs.com

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1622160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622160000000",
    "number": "1023684289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 NORTH JEFFERSON STREET",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "24901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 NORTH JEFFERSON STREET",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "24901",
            "telephone_number": "304-647-6529",
            "fax_number": "304-647-1273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MABALOT",
        "first_name": "MARINELLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-28",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisburg, WV

Sources for this page

Verify at the official NPI Registry.