Individual provider Active NPI

Marni Jae Sanders, M.D.

  • Obstetrics & Gynecology Physician
  • New Hyde Park, NY
National Provider Identifier
1215933304
Registry record updated Dec 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
215779 Issued in NY
Practice address
1 Hollow LN Ste 315
New Hyde Park, NY 11042-1215
Phone
(516) 437-4300
Fax
(516) 437-2033
NPI assigned
Jun 23, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 215779 NY Primary

Addresses

Primary practice location

1 Hollow LN Ste 315
New Hyde Park, NY 11042-1215

Mailing address

1 Hollow LN Ste 315
New Hyde Park, NY 11042-1215
Phone (516) 437-4300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20060215000275 NY Practitioner - Obstetrics/Gynecology 5496760241 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
State University of Ny Upstate Medical University, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marcus Avenue OB/GYN PCGroup PAC ID 9739625302, 8 clinicians

Practice addresses (Care Compare)

27005 75TH Ave
New Hyde Park, NY 11040-1402
Phone (516) 437-4300

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Women for Women Obstetrics & Gynecology,LLC CurrentSince Nov 30, 2001 Accepting new patients
Marcus Avenue OB/GYN, PC Obstetrics & Gynecology CurrentSince Jul 8, 2024 Accepting new patients
North Shore-Lij Medical PC Obstetrics & Gynecology PastSince Nov 30, 2001 Accepting new patients

Locations

410 Lakeville Rd
Ste 305
New Hyde Park, NY 11042
Phone (516) 437-4300

1 Hollow Ln
Ste 315
New Hyde Park, NY 11042
Phone (516) 437-4300

27005 76th Ave
North New Hyde Pk, NY 11040

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

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": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669852800000",
    "number": "1215933304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOLLOW LN STE 315",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421215",
            "telephone_number": "516-437-4300",
            "fax_number": "516-437-2033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOLLOW LN STE 315",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421215",
            "telephone_number": "516-437-4300",
            "fax_number": "516-437-2033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "MARNI",
        "middle_name": "JAE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-23",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "215779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.