Individual provider Active NPI

Marlene Minarik, PA-C

  • Medical Physician Assistant
  • Bronx, NY
National Provider Identifier
1114950425
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
002184 Issued in NY
Practice address
183Rd Street & 3Rd Avenue
St. Barnabas Hospital
Bronx, NY 10457
Phone
(718) 960-6274
Fax
(718) 960-9404
NPI assigned
Jul 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 002184 NY Primary

Addresses

Primary practice location

183Rd Street & 3Rd Avenue
St. Barnabas Hospital
Bronx, NY 10457

Mailing address

3611 Henry Hudson Pkwy Apt 4B
Bronx, NY 10463-1553
Phone (718) 960-6274

Other names 1

  • Marlene Calvo Former name

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

State licenses

LicenseStateTypeSpecialty
002184NYMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114950425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3611 HENRY HUDSON PKWY APT 4B",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104631553",
            "telephone_number": "718-960-6274",
            "fax_number": "718-960-9404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "183RD STREET & 3RD AVENUE",
            "address_2": "ST. BARNABAS HOSPITAL",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10457",
            "telephone_number": "718-960-6274",
            "fax_number": "718-960-9404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINARIK",
        "first_name": "MARLENE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "002184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARLENE",
            "last_name": "CALVO",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.