Individual provider Active NPI

John Louis Marini, P.A.

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1144325085
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085-002803 Issued in IL
Practice address
5025 N Paulina St
Chicago, IL 60640-2772
Phone
(773) 271-9040
NPI assigned
Sep 14, 2006
Sex
Male
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
Physician Assistant 363A00000X 085-002803 IL Primary

Addresses

Primary practice location

5025 N Paulina St
Chicago, IL 60640-2772

Mailing address

510 W Briar PL
Apt 104
Chicago, IL 60657-4625
Phone (630) 699-8165

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20120816000588 FL Practitioner - Physician Assistant 3072515972 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085-002803ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Em-I Medical Services, PA Physician Assistant CurrentSince Jan 1, 2025 Accepting new patients
Phoenix Emergency Medicine of Broward LLC CurrentSince Nov 20, 2013 Accepting new patients

Locations

17240 Cortez Blvd
Brooksville, FL 34601
Phone (352) 544-6060

1600 S Andrews Ave
Ft Lauderdale, FL 33316
Phone (954) 355-4000

6401 N Federal Hwy
Ft Lauderdale, FL 33308
Phone (954) 776-8500

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

3000 Coral Hills Dr
Pompano Beach, FL 33065
Phone (954) 344-3000

Organizations & group practices 4

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": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144325085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 W BRIAR PL",
            "address_2": "APT 104",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606574625",
            "telephone_number": "630-699-8165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5025 N PAULINA ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402772",
            "telephone_number": "773-271-9040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINI",
        "first_name": "JOHN",
        "middle_name": "LOUIS",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-002803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.