Individual provider Active NPI

William T Marshall, DO

  • Surgical Critical Care Physician
  • Valhalla, NY
National Provider Identifier
1174533061
Registry record updated Jan 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
296662 Issued in NY
Practice address
100 Woods Rd # a
Valhalla, NY 10595
Phone
(914) 493-7000
NPI assigned
Aug 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 044420 CT
Specialist 174400000X 044420 CT
Surgical Critical Care Physician 2086S0102X 296662 NY Primary

Addresses

Primary practice location

100 Woods Rd # a
Valhalla, NY 10595

Mailing address

19 Bradhurst Ave Ste 3100N
Hawthorne, NY 10532-2140
Phone (914) 909-9018

Other practice location 1

1000 Asylum Ave
Suite 4320
Hartford, CT 06105-1770
Phone (860) 714-5237

Other practice location 2

1000 Asylum Ave
Suite 4320
Hartford, CT 06105-1770
Phone (860) 714-5237

Other identifiers 1

IdentifierTypeStateIssuer
296662OtherNYNYS LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20060824000330 CT Practitioner - General Practice 2466455803 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
New York College of Osteo Medicine of New York Institute of Technology, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bristol Hospital Multi Specialty Group, Inc.Group PAC ID 9032014758, 148 clinicians

Practice addresses (Care Compare)

15 Riverside Ave
Bristol, CT 06010-6312
Phone (860) 585-3333

167 Main St
Southington, CT 06489-2505
Phone (860) 426-0252

41 Brewster Rd
Bristol, CT 06010-5161
Phone (860) 585-3000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Colonoscopy1-10
Hernia repair (minimally invasive)1-10
Pacemaker insertion or repair1-10
Melanoma (skin cancer) excision22
Removal of tissue17
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
044420CTMDSpecialist
296662NYMDSurgical Critical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bristol Hospital Multi Specialty Group, Inc Surgery CurrentSince Nov 4, 2019 Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Jul 17, 2006 Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Jul 17, 2006 Accepting new patients

Locations

41 Brewster Rd
Bristol, CT 06010
Phone (800) 585-3000

25 Newell Rd
Ste D28
Bristol, CT 06010
Phone (860) 582-1220

15 Riverside Ave
Bristol, CT 06010
Phone (860) 516-7593

1000 Asylum Ave
Ste 4320
Hartford, CT 06105

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

167 Main St
Southington, CT 06489
Phone (860) 426-0252

1000 Asylum Ave
Ste 2109A
West Hartford, CT 06105
Phone (860) 714-5058

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 2

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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548288000000",
    "number": "1174533061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 BRADHURST AVE STE 3100N",
            "city": "HAWTHORNE",
            "state": "NY",
            "postal_code": "105322140",
            "telephone_number": "914-909-9018",
            "fax_number": "914-909-9028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WOODS RD # A",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "10595",
            "telephone_number": "914-493-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Asylum Ave",
            "address_2": "Suite 4320",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061051770",
            "country_code": "US",
            "telephone_number": "860-714-5237",
            "fax_number": "860-714-8097",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Asylum Ave",
            "address_2": "Suite 4320",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061051770",
            "country_code": "US",
            "telephone_number": "860-714-5237",
            "fax_number": "860-714-8097",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "WILLIAM",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2019-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CT",
            "license": "044420",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CT",
            "license": "044420",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "NY",
            "license": "296662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS LICENSE",
            "identifier": "296662",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valhalla, NY

Sources for this page

Verify at the official NPI Registry.