Individual provider Active NPI

Lisa Anne Marrero, MD

  • Pediatrics Physician
  • New Rochelle, NY
National Provider Identifier
1164482329
Registry record updated Oct 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
206871 Issued in NY
Practice address
16 Guion PL
New Rochelle, NY 10801-5503
Phone
(914) 632-5000
NPI assigned
Mar 23, 2006
Last updated
Oct 10, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 206871 NY Primary

Addresses

Primary practice location

16 Guion PL
New Rochelle, NY 10801-5503

Mailing address

16 Guion PL
Iselin Hall, Room 107
New Rochelle, NY 10801-5503
Phone (914) 637-1357

Other identifiers 1

IdentifierTypeStateIssuer
01783004MedicaidNY

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
I20050928001332 NY Practitioner - Pediatric Medicine 4082649025 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Mount Vernon Hospital CurrentSince Jun 1, 2016 Accepting new patients
Montefiore New Rochelle Hospital CurrentSince Nov 6, 2013 Accepting new patients
Sound Shore Physician Services Past Accepting new patients
Montefiore New Rochelle Hospital Past Accepting new patients

Locations

12 N 7th Ave
Mount Vernon, NY 10550
Phone (914) 361-6511

16 Guion Pl
New Rochelle, NY 10801
Phone (914) 365-3680

16 Guion Pl
Rm 107
New Rochelle, NY 10801
Phone (914) 365-3160

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

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, 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": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191974400000",
    "number": "1164482329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 GUION PL",
            "address_2": "ISELIN HALL, ROOM 107",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108015503",
            "telephone_number": "914-637-1357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 GUION PL",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108015503",
            "telephone_number": "914-632-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARRERO",
        "first_name": "LISA",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-23",
        "last_updated": "2007-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "206871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01783004",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Rochelle, NY

Sources for this page

Verify at the official NPI Registry.