Individual provider Active NPI

Martin Charles Marmorale, D.C.

  • Chiropractor
  • Bellmore, NY
National Provider Identifier
1144361312
Registry record updated Jun 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X004607-1 Issued in NY
Practice address
2307 Bellmore Ave Unit a
Bellmore, NY 11710-5651
Phone
(516) 679-2225
Fax
(516) 977-1319
NPI assigned
Feb 9, 2007
Last updated
Jun 8, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X004607-1 NY Primary

Addresses

Primary practice location

2307 Bellmore Ave Unit a
Bellmore, NY 11710-5651

Mailing address

2307 Bellmore Ave Unit a
Bellmore, NY 11710-5651
Phone (516) 679-2225

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090909000484 NY Practitioner - Chiropractic 1254486566 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1986
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2473 Merrick Rd
Bellmore, NY 11710-5705
Phone (516) 679-2225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X004607-1NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
East Bay Chiropractic Wellnes PC Chiropractor CurrentSince Apr 23, 2018 Accepting new patients
Fit for Life Physical Therapy PC PastSince Apr 23, 2018 Accepting new patients

Locations

2473 Merrick Rd
Bellmore, NY 11710
Phone (516) 679-2225

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244419200000",
    "number": "1144361312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2307 BELLMORE AVE UNIT A",
            "city": "BELLMORE",
            "state": "NY",
            "postal_code": "117105651",
            "telephone_number": "516-679-2225",
            "fax_number": "516-977-1319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2307 BELLMORE AVE UNIT A",
            "city": "BELLMORE",
            "state": "NY",
            "postal_code": "117105651",
            "telephone_number": "516-679-2225",
            "fax_number": "516-977-1319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARMORALE",
        "first_name": "MARTIN",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2009-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X004607-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellmore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.