Marnella Elizalde, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209019916 Issued in IL

Practice address

109 Fairfield Way Ste 207
Bloomingdale, IL 60108-1500

Phone

(630) 915-2037

NPI assigned

Sep 26, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Elizalde Healthcare SC

  • Family Medicine Physician
  • Glendale Heights, IL
  • NPI 1710712070
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1569456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610409600000",
    "number": "1184275448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 FAIRFIELD WAY STE 205",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601081500",
            "telephone_number": "630-915-2037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 FAIRFIELD WAY STE 207",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601081500",
            "telephone_number": "630-915-2037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELIZALDE",
        "first_name": "MARNELLA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-26",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209019916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Patrick Durkin, DC
• Ears in Bloom Audiology, LLC
• Jasmin L Eco, D.D.S.
• Zachary Edsey
• Elevating Resilience Counseling LLC
• Elmhurst Dental Group, LTD Dba Bloomingdale Dental
• Elmhurst Memorial Healthcare
• Empower Psychiatry PLLC
• William L Epperly, MD
• Ericka Axness, LCSW and Associates, LLC

• Family Nurse Practitioner in Bloomingdale, IL
• Providers in Bloomingdale, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.