Individual provider Active NPI

Lisa Joanna Marcano

  • Acute Care Nurse Practitioner
  • New York, NY
National Provider Identifier
1104172014
Registry record updated Jul 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
F430611-1 Issued in NY
Practice address
1 Gustave L Levy PL
New York, NY 10029-6500
Phone
(212) 241-6500
NPI assigned
Jul 29, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 561531-1 NY
Acute Care Nurse Practitioner 363LA2100X F430611-1 NY Primary

Addresses

Primary practice location

1 Gustave L Levy PL
New York, NY 10029-6500

Mailing address

19 E 98TH St
1-A
New York, NY 10029-6501
Phone (212) 241-9061

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150805006439 NY Practitioner - Nurse Practitioner 5698089605 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
561531-1NYMDRegistered Nurse
F430611-1NYMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Jan 2, 2015 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jan 2, 2015 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

Locations

150 E 42nd St
#10
New York, NY 10017

1190 5th Ave
Ste GP2W
New York, NY 10029

1190 5th Ave
#2W
New York, NY 10029
Phone (212) 241-5646

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • 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.

NPI Registry JSON

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

{
    "created_epoch": "1343520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343520000000",
    "number": "1104172014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 E 98TH ST",
            "address_2": "1-A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296501",
            "telephone_number": "212-241-9061"
        },
        {
            "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": "100296500",
            "telephone_number": "212-241-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCANO",
        "first_name": "LISA",
        "middle_name": "JOANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-29",
        "last_updated": "2012-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "561531-1",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "F430611-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.