Individual provider Active NPI

Shreen Marini, FNP-BC

  • Family Nurse Practitioner
  • Dearborn, MI
National Provider Identifier
1033821996
Registry record updated Jun 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704330311 Issued in MI
Practice address
2040 Monroe St Ste 206
Dearborn, MI 48124-2950
Phone
(313) 757-7647
NPI assigned
Dec 21, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 4704330311 MI
Family Nurse Practitioner 363LF0000X 4704330311 MI Primary

Addresses

Primary practice location

2040 Monroe St Ste 206
Dearborn, MI 48124-2950

Mailing address

4614 Curtis St
Dearborn, MI 48126-4152
Phone (313) 670-4207

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250904004706 MI Practitioner - Nurse Practitioner 2466954912 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Detroit Mercy School of Dentistry, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2040 Monroe St
Suite 206
Dearborn, MI 48124-2950

3250 Lacey Rd
Suite 160
Downers Grove, IL 60515-7901

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
DRS Extended Care PLLC CurrentSince Jul 10, 2025 Accepting new patients
Thamer Medical PLLC CurrentSince Jul 1, 2025 Accepting new patients

Locations

2040 Monroe St
Ste 206
Dearborn, MI 48124
Phone (313) 565-6782

Organizations & group practices 2

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": "1671580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751155200000",
    "number": "1033821996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4614 CURTIS ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481264152",
            "telephone_number": "313-670-4207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 MONROE ST STE 206",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242950",
            "telephone_number": "313-757-7647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINI",
        "first_name": "SHREEN",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-21",
        "last_updated": "2025-06-29",
        "certification_date": "2025-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "MI",
            "license": "4704330311",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704330311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.