Active NPI
Marilyn C Coruzzi, MD
- Internal Medicine Physician
- Sitka, AK
National Provider Identifier
1053487587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 3781
- Practice address
- 209 Moller Ave
Sitka Community Hospital
Sitka, AK 99835-7142 - Phone
- (907) 474-1722
- Fax
- (907) 747-1755
- NPI assigned
- Nov 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 3781 | AK | Primary |
Addresses
Primary practice location
209 Moller Ave
Sitka Community Hospital
Sitka, AK 99835-7142
Mailing address
209 Moller Ave
Sitka Community Hospital
Sitka, AK 99835-7142
Phone (907) 474-1722
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MD37811 | Medicaid | AK |
Other names 1
- Mrs. Marilyn Coruzzi Wise
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3781 | AK | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Moore Clinic Inc | Internal Medicine | Past | Accepting new patients |
Organizations & group practices 1
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": "1164585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357689600000",
"number": "1053487587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "209 MOLLER AVE",
"address_2": "SITKA COMMUNITY HOSPITAL",
"city": "SITKA",
"state": "AK",
"postal_code": "998357142",
"telephone_number": "907-474-1722",
"fax_number": "907-747-1755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "209 MOLLER AVE",
"address_2": "SITKA COMMUNITY HOSPITAL",
"city": "SITKA",
"state": "AK",
"postal_code": "998357142",
"telephone_number": "907-474-1722",
"fax_number": "907-747-1755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORUZZI",
"first_name": "MARILYN",
"middle_name": "C",
"name_prefix": "Mrs.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-27",
"last_updated": "2013-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "AK",
"license": "3781",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "MD37811",
"state": "AK"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MARILYN",
"last_name": "WISE",
"middle_name": "CORUZZI",
"prefix": "MRS.",
"credential": "MD",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Sitka, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.