Individual provider Active NPI

Marie Vian Dino Espiritu, PA-C

  • Physician Assistant
  • New York, NY
National Provider Identifier
1104611524
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
033602 Issued in NY
Practice address
462 1St Ave
New York, NY 10016-9196
Phone
(212) 562-5555
NPI assigned
Apr 14, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 033602 NY Primary

Addresses

Primary practice location

462 1St Ave
New York, NY 10016-9196

Mailing address

6328 Loudon Ave
Elkridge, MD 21075-5635

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
I20250702001358 NY Order and Referring Only - Physician Assistant 4688187677

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
033602NYMDPhysician Assistant

Networks

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

Interoperability endpoints

  • Direct secure messaging: mespiritu3756705@nychhc.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1744588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1104611524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6328 LOUDON AVE",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210755635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "462 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100169196",
            "telephone_number": "212-562-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESPIRITU",
        "first_name": "MARIE VIAN",
        "middle_name": "DINO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-14",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "033602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.