Michael St. Marie, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

35064462S Issued in OH

Practice address

2420 Lake Ave
Ashtabula, OH 44004-4954

Phone

(440) 997-2262

NPI assigned

May 27, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Phoebe Putney Memorial Hospital Inc

  dba Phoebe Putney Memorial Hosptial

  • General Acute Care Hospital
  • Albany, GA
  • NPI 1992789721
  Medicare reassignment NPD
• Phoebe Worth Medical Center, Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Sylvester, GA
  • NPI 1760460448
  Medicare reassignment NPD
• Phoebe Putney Memorial Hospital Inc

  dba Phoebe Specialty Pharmacy

  • Community/Retail Pharmacy
  • Albany, GA
  • NPI 1891315420
  NPD
• Phoebe Women's Services

  • Obstetrics & Gynecology Physician
  • Albany, GA
  • NPI 1639338320
  NPD
• Phoebe Worth Medical Center, Inc

  dba Phoebe Family Medicine

  • Rural Health Clinic/Center
  • Ashburn, GA
  • NPI 1144205014
  NPD
• Physicians Link Center LLC

  • Emergency Medicine Physician
  • Elyria, OH
  • NPI 1235172925
  NPD (past)
• Southwestern Emergency Physicians PC

  • Emergency Medicine Physician
  • Albany, GA
  • NPI 1356336986
  NPD (past)

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114974219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32945 CANTERBURY RD",
            "city": "AVON LAKE",
            "state": "OH",
            "postal_code": "440121587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2420 LAKE AVE",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440044954",
            "telephone_number": "440-997-2262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST. MARIE",
        "first_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35064462S",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE",
            "identifier": "942460636340",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE TRAVELERS RR-GA",
            "identifier": "P00220354",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0573937",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anna Spencer, COTA
• Lauren Elizabeth Sposito, ATC
• Square One Health LLC
• Square One Health LLC
• Sanjay Kumar Srivastava
• David N. Stanco
• Sherri Pearl Starr
• State Road Occupational Medical Facility LLC
• Luke Stecki
• Deanne L Steele, SWA

• Emergency Medicine Physician in Ashtabula, OH
• Providers in Ashtabula, OH by specialty
• Emergency Medicine Physician in Ohio

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.