Individual provider Active NPI

Marie Anne Nely Germain, MD

  • Student in an Organized Health Care Education/Training Program
  • Paterson, NJ
National Provider Identifier
1053064162
Registry record updated Jan 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
HSE29924 Issued in FL
Practice address
425 15TH Ave
Paterson, NJ 07504-1811
Phone
(973) 345-4024
NPI assigned
Jan 28, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2022

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 HSE29924 FL Primary

Addresses

Primary practice location

425 15TH Ave
Paterson, NJ 07504-1811

Mailing address

21 Maplewood Blvd
Suffern, NY 10901-7632
Phone (845) 598-0582

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
HSE29924FLMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Revoredo Medical Affiliates LLC PastSince Feb 1, 2022 Accepting new patients
Elite Premier Medical Care LLC PastSince Feb 1, 2022 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FAJEDD

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": "1643328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643328000000",
    "number": "1053064162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 MAPLEWOOD BLVD",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109017632",
            "telephone_number": "845-598-0582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 15TH AVE",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075041811",
            "telephone_number": "973-345-4024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERMAIN",
        "first_name": "MARIE ANNE NELY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-28",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "HSE29924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paterson, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2022; 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.