Individual provider Active NPI

Bridget Kelly Marcellino

  • Medical Oncology Physician
  • New York, NY
National Provider Identifier
1093133589
Registry record updated Jan 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
295942 Issued in NY
Practice address
1 Gustave L Levy PL
New York, NY 10029-6504
Phone
(212) 241-6756
NPI assigned
Apr 1, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology (Internal Medicine) Physician 207RH0000X 295942 NY
Medical Oncology Physician 207RX0202X 295942 NY Primary

Addresses

Primary practice location

1 Gustave L Levy PL
New York, NY 10029-6504

Mailing address

150 E 42ND St FL 9
New York, NY 10017-5699
Phone (646) 605-8186

Other practice location 1

10 E 102nd St
New York, NY 10029-6030
Phone (212) 241-6756

Other practice location 2

1470 Madison Ave
New York, NY 10029-6542
Phone (212) 241-7012

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200201000024 NY Practitioner - Medical Oncology 1850727397 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Medical Oncology
Education
Icahn School of Medicine at Mount Sinai, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Icahn School of Medicine at Mount SinaiGroup PAC ID 2264691070, 2,809 clinicians

Practice addresses (Care Compare)

10 Union Square E
Tisch Dept of Mount Sinai
New York, NY 10003-3314
Phone (212) 844-8288

5 E 98TH St
Suite 6
New York, NY 10029-6501
Phone (212) 241-4812

5 E 98TH St 12TH Floor
Tisch Department of Mount Sinai
New York, NY 10029-6501
Phone (212) 241-8303

Hospital & facility affiliations

  • Mount Sinai Hospital Hospital, New York, NY, CCN 330024
  • Mount Sinai Beth Israel Hospital, New York, NY, CCN 330169

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
295942NYMDMedical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Jan 1, 2020 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jan 1, 2020 Accepting new patients
Mount Sinai Hospital Past Accepting new patients

Locations

1470 Madison Ave
New York, NY 10029
Phone (212) 241-0806

17 E 102nd St
Fl 7
New York, NY 10029
Phone (212) 659-8551

10 E 102nd St
New York, NY 10029
Phone (212) 241-5656

150 E 42nd St
Fl 9
New York, NY 10017
Phone (646) 605-8119

5 E 98th St
Fl 12
New York, NY 10029
Phone (212) 241-8303

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Organizations & group practices 3

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1396310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578528000000",
    "number": "1093133589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 E 42ND ST FL 9",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100175699",
            "telephone_number": "646-605-8186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296504",
            "telephone_number": "212-241-6756"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 E 102nd St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100296030",
            "country_code": "US",
            "telephone_number": "212-241-6756",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1470 Madison Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100296542",
            "country_code": "US",
            "telephone_number": "212-241-7012",
            "fax_number": "212-241-8445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARCELLINO",
        "first_name": "BRIDGET",
        "middle_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-01",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "NY",
            "license": "295942",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "NY",
            "license": "295942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.