Individual provider Active NPI

Marie Therese Dorcely, M.D.

  • Family Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1043212475
Registry record updated Dec 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
130687 Issued in NY
Practice address
210 Montrose Ave
Brooklyn, NY 11206-2707
Phone
(718) 497-1764
Fax
(718) 381-6652
NPI assigned
Aug 15, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 130687 NY Primary

Addresses

Primary practice location

210 Montrose Ave
Brooklyn, NY 11206-2707

Mailing address

29 Woodland Rd
Roslyn, NY 11576-1435
Phone (516) 365-6316

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
130687NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323043200000",
    "number": "1043212475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 WOODLAND RD",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115761435",
            "telephone_number": "516-365-6316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 MONTROSE AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112062707",
            "telephone_number": "718-497-1764",
            "fax_number": "718-381-6652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORCELY",
        "first_name": "MARIE",
        "middle_name": "THERESE",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-15",
        "last_updated": "2011-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "130687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.