Individual provider Active NPI

Marcel Cesar Casasola Medrano, MD

  • Pulmonary Disease Physician
  • New Brunswick, NJ
National Provider Identifier
1184112591
Registry record updated Aug 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
25MA11134400 Issued in NJ
Practice address
125 Paterson St Ste 5200B
New Brunswick, NJ 08901-1962
Phone
(857) 492-4650
NPI assigned
May 1, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 276935 MA
Student in an Organized Health Care Education/Training Program 390200000X MA
Pulmonary Disease Physician 207RP1001X 25MA11134400 NJ Primary

Addresses

Primary practice location

125 Paterson St Ste 5200B
New Brunswick, NJ 08901-1962

Mailing address

1 Richmond St Apt 2100
New Brunswick, NJ 08901-4505
Phone (857) 492-4650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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
I20240903000293 ME Practitioner - Pulmonary Disease 9537416169 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Eastern Maine Medical CenterGroup PAC ID 2062315161, 659 clinicians

Practice addresses (Care Compare)

417 State St
Suite 20
Bangor, ME 04401-6637
Phone (207) 275-1500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.1 of 100Reported as group
Quality
64.8
Promoting interoperability
96
Improvement activities
40
Cost
68.87

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
276935MAMDInternal Medicine Physician
25MA11134400NJMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Maine Medical Center CurrentSince Sep 15, 2024 Accepting new patients
Eastern Maine Medical Center CurrentSince Sep 15, 2024 Accepting new patients

Locations

489 State St
Bangor, ME 04401
Phone (207) 973-8837

489 State St
Ste A
Bangor, ME 04401

417 State St
Ste 20
Bangor, ME 04401
Phone (207) 973-7478

43 Whiting Hill Rd
Ste 250
Brewer, ME 04412

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.

Hospital & facility affiliations 5

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": "1525132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629590400000",
    "number": "1184112591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 RICHMOND ST APT 2100",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089014505",
            "telephone_number": "857-492-4650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 PATERSON ST STE 5200B",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011962",
            "telephone_number": "857-492-4650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASASOLA MEDRANO",
        "first_name": "MARCEL",
        "middle_name": "CESAR",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-01",
        "last_updated": "2021-08-22",
        "certification_date": "2021-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "276935",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MA",
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NJ",
            "license": "25MA11134400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Brunswick, NJ

Sources for this page

Verify at the official NPI Registry.