Individual provider Active NPI

Eng Mee Moong Marilyn Pan, CNM

  • Advanced Practice Midwife
  • New York, NY
National Provider Identifier
1225017536
Registry record updated Sep 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
F000340 Issued in NY
Practice address
48 Market St
2M
New York, NY 10002-8400
Phone
(212) 766-9751
Fax
(212) 766-1158
NPI assigned
Jan 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X F000340 NY Primary

Addresses

Primary practice location

48 Market St
2M
New York, NY 10002-8400

Mailing address

48 Market St
2M
New York, NY 10002-8400
Phone (212) 766-9751

Other identifiers 1

IdentifierTypeStateIssuer
01944509MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
F000340NYMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Lighthouse Pediatrics, PC Past Accepting new patients
St Vincents Hospital and Medical Center Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475020800000",
    "number": "1225017536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 MARKET ST",
            "address_2": "2M",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100028400",
            "telephone_number": "212-766-9751",
            "fax_number": "212-766-1158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 MARKET ST",
            "address_2": "2M",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100028400",
            "telephone_number": "212-766-9751",
            "fax_number": "212-766-1158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAN",
        "first_name": "ENG MEE MOONG",
        "middle_name": "MARILYN",
        "name_prefix": "Ms.",
        "credential": "CNM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-13",
        "last_updated": "2016-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NY",
            "license": "F000340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01944509",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.