Individual provider Active NPI

Daniel Joseph Marino, MD

  • Emergency Medicine Physician
  • Lafayette, IN
National Provider Identifier
1164659074
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
01069703A Issued in IN
Practice address
1701 S Creasy LN
Lafayette, IN 47905-4972
Phone
(800) 654-9410
NPI assigned
Jun 18, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 01069703A IN Primary

Addresses

Primary practice location

1701 S Creasy LN
Lafayette, IN 47905-4972

Mailing address

14107 Gemma
San Antonio, TX 78253-4787
Phone (607) 743-9835

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120920000787 IN Practitioner - Emergency Medicine 4082862719 Reassigns benefits to 1 organization
I20200310001238 TX Practitioner - Emergency Medicine 4082862719 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
State University of New York at Stony Brook, School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clarksville Emergency Group PCGroup PAC ID 6507277423, 149 clinicians

Practice addresses (Care Compare)

1701 S Creasy LN
Franciscan Health Lafayette East
Lafayette, IN 47905-4972
Phone (765) 502-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01069703AINMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Travis County Emergency Physicians PA Emergency Medicine CurrentSince Feb 10, 2020 Accepting new patients
Clarksville Emergency Group, PC Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients
Third Coast Emergency Physicians Southwest PA Emergency Medicine CurrentSince Feb 10, 2020 Accepting new patients

Locations

1141 Hospital Dr NW
Corydon, IN 47112
Phone (812) 738-7830

1701 S Creasy Ln
Lafayette, IN 47905
Phone (765) 502-4400

7900 Ranch Road 1826
Austin, TX 78737
Phone (512) 324-5305

630 W State Highway 71
Bastrop, TX 78602
Phone (737) 881-7400

6001 Kyle Pkwy
Kyle, TX 78640
Phone (512) 504-5000

100 Medical Pkwy
Lakeway, TX 78738
Phone (512) 206-8100

8811 Village Dr
San Antonio, TX 78217
Phone (210) 297-2000

4103 N Loop 1604 W
San Antonio, TX 78249
Phone (210) 572-8415

520 Madison Oak Dr
San Antonio, TX 78258
Phone (210) 297-0412

3333 Research Plz
San Antonio, TX 78235
Phone (210) 297-3000

111 Dallas St
San Antonio, TX 78205
Phone (210) 297-7000

7930 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 297-5000

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

Interoperability endpoints

  • Direct secure messaging: dmarino163808@direct.franciscanalliance.org

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1245283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1164659074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14107 GEMMA",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782534787",
            "telephone_number": "607-743-9835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 S CREASY LN",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479054972",
            "telephone_number": "800-654-9410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINO",
        "first_name": "DANIEL",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-18",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01069703A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

Verify at the official NPI Registry.