Individual provider Active NPI

Janette Marcelo, M.D.

  • Internal Medicine Physician
  • Manhasset, NY
National Provider Identifier
1144337122
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
163914 Issued in NY
Practice address
1155 Northern Blvd
Manhasset, NY 11030-3040
Phone
(516) 407-4000
NPI assigned
Aug 24, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 163914 NY Primary

Addresses

Primary practice location

1155 Northern Blvd
Manhasset, NY 11030-3040

Mailing address

50 Deepdale Pkwy
Roslyn Heights, NY 11577-2302
Phone (516) 528-8502

Other identifiers 3

IdentifierTypeStateIssuer
478197OtherNYUNITED HEALTHCARE
P601994OtherNYOXFORD
00946323MedicaidNY

Other names 1

  • Dr. Janette Yap-Marcelo Other name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100128000001 NY Practitioner - Internal Medicine 1759423833 Reassigns benefits to 1 organization
Practice locations: Middle Village, NY; Roslyn, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
163914NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Medical Group of the Mount Sinai School of Medicine Single Specialty CurrentSince Feb 1, 2020 Accepting new patients
North Shore Medical Group of the Mount Sinai School of Medicine Internal Medicine CurrentSince Feb 1, 2020 Accepting new patients

Locations

325 Park Ave
Huntington, NY 11743
Phone (631) 351-3700

1155 Northern Blvd
Manhasset, NY 11030
Phone (516) 407-4000

8452 63rd Ave
Middle Vlg, NY 11379
Phone (718) 446-4600

9901 Queens Blvd
Rego Park, NY 11374
Phone (718) 268-4500

100 Port Washington Blvd
Roslyn, NY 11576
Phone (516) 562-6385

Organizations & group practices 2

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": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1144337122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 DEEPDALE PKWY",
            "city": "ROSLYN HEIGHTS",
            "state": "NY",
            "postal_code": "115772302",
            "telephone_number": "516-528-8502",
            "fax_number": "718-446-0727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 NORTHERN BLVD",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303040",
            "telephone_number": "516-407-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCELO",
        "first_name": "JANETTE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "163914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "478197",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P601994",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00946323",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANETTE",
            "last_name": "YAP-MARCELO",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Manhasset, NY

Sources for this page

Verify at the official NPI Registry.