Philip Charles Marin, MD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

40500 Issued in CO

Practice address

1304 N Grand Ave
Pueblo, CO 81003-2718

Phone

(719) 669-8487

Fax

(719) 669-8488

NPI assigned

Jul 7, 2006

Last updated

Apr 5, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 7

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CO

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

Specialty

Plastic and Reconstructive SurgeryAlso: Hand Surgery

Education

University of North Dakota School of Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Parkview Medical Center, Inc Hospital, Pueblo, CO, CCN 060020

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Philip C. Marin, MD Prof LLC

  • Plastic Surgery Physician
  • Pueblo, CO
  • NPI 1497934558
  Medicare reassignment NPD Authorized official
• Union Memorial Hospital

  • Multi-Specialty Clinic/Center
  • Baltimore, MD
  • NPI 1336163781
  NPD (past)

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

• Parkview Medical Center, Inc

  • General Acute Care Hospital
  • Pueblo, CO
  • NPI 1184263527
  Care Compare affiliation
• Parkview Medical Center, Inc

  • General Acute Care Hospital
  • Pueblo, CO
  • NPI 1376183145
  Care Compare affiliation
• Parkview Medical Center, Inc

  • General Acute Care Hospital
  • Pueblo, CO
  • NPI 1417596834
  Care Compare affiliation
• Parkview Medical Center, Inc

  • General Acute Care Hospital
  • Pueblo, CO
  • NPI 1427689652
  Care Compare affiliation
• Parkview Medical Center, Inc.

  dba Parkview Medical Center

  • General Acute Care Hospital
  • Pueblo, CO
  • NPI 1104881507
  Care Compare affiliation
• Parkview Medical Center, Inc.

  • General Acute Care Hospital
  • Pueblo, CO
  • NPI 1134751712
  Care Compare affiliation
• Parkview Medical Center, Inc.

  dba Parkview Pueblo West

  • General Acute Care Hospital
  • Pueblo West, CO
  • NPI 1821720681
  Care Compare affiliation

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1205868544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 N GRAND AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032718",
            "telephone_number": "719-669-8487",
            "fax_number": "719-669-8488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 N GRAND AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032718",
            "telephone_number": "719-669-8487",
            "fax_number": "719-669-8488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARIN",
        "first_name": "PHILIP",
        "middle_name": "CHARLES",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2023-04-05",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CO",
            "license": "40500",
            "primary": true
        },
        {
            "code": "2082S0105X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "CO",
            "license": "40500",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "CO",
            "license": "0040500",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "TDDIR",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED OF OMAHA",
            "identifier": "71412",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "MA65799",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00213540",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMO CO",
            "identifier": "00073",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA GOLD",
            "identifier": "61101",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSURANCE",
            "identifier": "00320",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Symplast",
            "affiliation": "N",
            "address_1": "1304 N Grand Ave",
            "city": "Pueblo",
            "state": "CO",
            "country_code": "US",
            "postal_code": "810032718",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Madorey Mares
• Raya Marfitano
• Brianna Promise Marhofer
• Maria a Rodriguez, PH.D.
• Dominic P Marin
• Jose Mariscal
• Mark D. Hurd, D.D.S.
• Kelsey Lynn Markenson, FNP-BC, AGACNP-BC
• Lisa Markley
• Brianna Jo Markowski

• Plastic Surgery Physician in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Plastic Surgery Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2023; 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.