Antonio Dante Marino, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.PA.60980056 Issued in WA

Practice address

707 W 13TH St
Vancouver, WA 98660-2809

Phone

(360) 397-2211

NPI assigned

Oct 14, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lifeline ConnectionsGroup PAC ID 2860758307, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Lifeline Connections

  • Substance Abuse Rehabilitation Facility
  • Vancouver, WA
  • NPI 1689892473
  Medicare reassignment Care Compare group NPD
• Lifeline Connections Medical Services

  • Primary Care Clinic/Center
  • Vancouver, WA
  • NPI 1245819887
  NPD

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

{
    "created_epoch": "1571011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571097600000",
    "number": "1053953760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3914 G ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986631838",
            "telephone_number": "360-907-9461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 W 13TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986602809",
            "telephone_number": "360-397-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINO",
        "first_name": "ANTONIO",
        "middle_name": "DANTE",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-10-14",
        "last_updated": "2019-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA.PA.60980056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Audrey Marie, CG, ATR-P
• Mary Ruth Marigomen
• Maria Marin
• Miranda Rose Maring, NP
• Andrew Marino, DC
• Jeaneclaryn Marino
• Joe A Marion, MD
• Mariposa Massage LLC (Mariposa Massage)
• Lucas A. Mariscal, CDPT
• Lindsey Marjama-Taft

• Physician Assistant in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.