Richard Marcolini, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

4301048829 Issued in MI

Practice address

22811 Greater Mack Ave Ste 104
Saint Clair Shores, MI 48080-2053

Phone

(586) 498-9933

NPI assigned

Feb 21, 2007

Sex

Male

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Neighborhood Service Organization

  • Community/Behavioral Health Agency
  • Detroit, MI
  • NPI 1891825808
  NPD

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265577571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22811 GREATER MACK AVE STE 104",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480802053",
            "telephone_number": "586-498-9933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22811 GREATER MACK AVE STE 104",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480802053",
            "telephone_number": "586-498-9933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCOLINI",
        "first_name": "RICHARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301048829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Louay G Mansour, D.D.S.
• Mohamed Bosher Mansour, MD
• Shiva J Maralani, MD
• Henry Marcano
• Raechel Lynn Marcano
• Rhetta Faye C Maribao, DO
• Vincent Colina Maribao, MD
• Marie-Claire Maroun M.D. PC
• Jennifer Kay Marino, NP
• Sara Rian Marino, LMSW, LMFT

• Psychiatry Physician in Saint Clair Shores, MI
• Providers in Saint Clair Shores, MI by specialty
• Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.