Individual provider Active NPI

Brenda Marmol, MD

  • Student in an Organized Health Care Education/Training Program
  • New York, NY
National Provider Identifier
1235699125
Registry record updated Apr 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1275 York Ave
New York, NY 10065-6007
Phone
(646) 888-0200
NPI assigned
Mar 25, 2019
Last updated
Apr 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary

Addresses

Primary practice location

1275 York Ave
New York, NY 10065-6007

Mailing address

1275 York Ave
New York, NY 10065-6007

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
I20240702000824 NY Practitioner - Psychiatry 7113461138 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Francis HospitalGroup PAC ID 9234101221, 96 clinicians
Mercy Medical CenterGroup PAC ID 4082518006, 83 clinicians
St Charles Hospital CorpGroup PAC ID 6103733050, 62 clinicians
St. Joseph HospitalGroup PAC ID 1254222938, 101 clinicians

Practice addresses (Care Compare)

100 Port Washington Blvd
Roslyn, NY 11576-1347
Phone (631) 669-2255

1000 Montauk Hwy
West Islip, NY 11795-4927
Phone (631) 376-3000

1000 N Village Ave
Rockville Center, NY 11570-1000
Phone (516) 705-3428

200 Belle Terre Rd
Port Jefferson, NY 11777-1928
Phone (631) 474-6000

4295 Hempstead Tpke
Bethpage, NY 11714-5713
Phone (516) 579-6000

50 Route 25a
Smithtown, NY 11787-1348
Phone (631) 862-3000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Medical Center CurrentSince May 1, 2025 Accepting new patients
St. Catherine of Siena Medical Center CurrentSince Jul 1, 2024 Accepting new patients
Mercy Medical Center CurrentSince May 1, 2025 Accepting new patients
St Charles Hospital Corp CurrentSince May 1, 2025 Accepting new patients
Good Samaritan Hospital Medical Center Current Accepting new patients
St. Francis Hospital CurrentSince May 1, 2025 Accepting new patients
Good Samaritan Hospital Medical CurrentSince May 1, 2025 Accepting new patients
Mercy Medical Center Current Accepting new patients
St Francis Hospital United States Catholic Conference CurrentSince May 1, 2025 Accepting new patients
St. Francis Hospital Current Accepting new patients
St. Joseph Hospital CurrentSince May 1, 2025 Accepting new patients
St. Catherine of Siena Medical Center Past Accepting new patients
St. Catherine of Siena Medical Center Past Accepting new patients

Locations

4295 Hempstead Tpke
Bethpage, NY 11714
Phone (516) 520-2250

245 Old Country Rd
Melville, NY 11747
Phone (631) 465-6141

200 Belle Terre Rd
Prt Jefferson, NY 11777
Phone (631) 474-6000

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

100 Port Washington Blvd
Roslyn, NY 11576
Phone (516) 562-6385

50 Route 25A
Smithtown, NY 11787
Phone (631) 465-6225

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

Networks

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

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 3

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": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1235699125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 YORK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 YORK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656007",
            "telephone_number": "646-888-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARMOL",
        "first_name": "BRENDA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-25",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.