Active NPI
Jaclyn Marino, DPM, DRPH, MPH
- Foot & Ankle Surgery Podiatrist
- Miami, FL
National Provider Identifier
1033406848
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- PO3725
- Practice address
- 1201 NW 16TH St
Miami, FL 33125-1624 - Phone
- (305) 575-7000
- NPI assigned
- Jun 30, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | RESIDENT | FL | |
| Foot & Ankle Surgery Podiatrist | 213ES0103X | PO3725 | FL | Primary |
| Foot & Ankle Surgery Podiatrist | 213ES0103X | SC006532 | PA |
Addresses
Primary practice location
1201 NW 16TH St
Miami, FL 33125-1624
Mailing address
1201 NW 16TH St
Miami, FL 33125-1624
Phone (305) 575-7000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RESIDENT | FL | MD | Anesthesiology Physician |
| PO3725 | FL | MD | Foot & Ankle Surgery Podiatrist |
| SC006532 | PA | MD | Foot & Ankle Surgery Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433203200000",
"number": "1033406848",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1201 NW 16TH ST",
"city": "MIAMI",
"state": "FL",
"postal_code": "331251624",
"telephone_number": "305-575-7000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 NW 16TH ST",
"city": "MIAMI",
"state": "FL",
"postal_code": "331251624",
"telephone_number": "305-575-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARINO",
"first_name": "JACLYN",
"name_prefix": "Dr.",
"credential": "DPM, DRPH, MPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-06-30",
"last_updated": "2015-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "FL",
"license": "RESIDENT",
"primary": false
},
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "FL",
"license": "PO3725",
"primary": true
},
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "PA",
"license": "SC006532",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.