Mariellen Dentino, M.D.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

1024941 Issued in IN

Practice address

3801 Bellemeade Ave Ste 330
Evansville, IN 47714-0113

Phone

(812) 479-3125

NPI assigned

Jul 28, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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

NephrologyAlso: Internal Medicine

Education

Indiana University School of Medicine, 1973

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Marys Medical Group LLCGroup PAC ID 1153493341, 230 clinicians

Nephrology Associates, LLCGroup PAC ID 4688610637, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• DaVita Jasper Dialysis Dialysis facility, Jasper, IN, CCN 152523
• DaVita Paoli Dialysis Dialysis facility, Paoli, IN, CCN 152652
• Ascension St Vincent Evansville Hospital, Evansville, IN, CCN 150100

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

96.46

Promoting interoperability

100

Improvement activities

40

Cost

79.66

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 and National Provider Directory roles.

• Nephrology Associates, LLC

  • Nephrology Physician
  • Evansville, IN
  • NPI 1467403758
  Medicare reassignment Care Compare group
• St Mary's Medical Group, LLC

  dba Ascension Medical Group St. Vincent Evansville

  • Family Medicine Physician
  • Evansville, IN
  • NPI 1164852539
  Medicare reassignment Care Compare group
• Primary Physicians Network LLC

  • Family Medicine Physician
  • Evansville, IN
  • NPI 1578786612
  NPD
• St. Vincent Medical Group, Inc.

  dba Ascension Medical Group St. Vincent

  • Internal Medicine Physician
  • Carmel, IN
  • NPI 1811881527
  NPD (past)

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

• Renal Life Link Inc

  dba Jasper Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Jasper, IN
  • NPI 1114983046

  Dialysis facility

  Care Compare affiliation Name & address match
• Total Renal Care Inc

  dba Paoli Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Paoli, IN
  • NPI 1538457809

  Dialysis facility

  Care Compare affiliation Name & address match
• St. Mary's Health, Inc.

  dba Ascension St. Vincent Evansville

  • General Acute Care Hospital
  • Evansville, IN
  • NPI 1427082957
  Care Compare affiliation

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655424000000",
    "number": "1275533622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 BELLEMEADE AVE STE 330",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 BELLEMEADE AVE STE 330",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140113",
            "telephone_number": "812-479-3125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENTINO",
        "first_name": "MARIELLEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-28",
        "last_updated": "2022-06-17",
        "certification_date": "2022-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IN",
            "license": "1024941",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100242750",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "390004294",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mariellen.dentino.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St Mary's Medical Group, LLC",
            "address_1": "3801 Bellemeade Ave Ste 330",
            "city": "Evansville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "477140113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dental Associates West, P.C.
• Dental Associates West, PC
• Dental Professionals of Indiana, P.C. (Evansville Family Dentistry)
• Dental Professionals of Indiana, P.C. (Diamond Valley Dental Care)
• Dentasafe LLC
• Jason R Denton, D.P.M.
• Katherine Marie Denton, M.A CCC-SLP
• John W. Deppe, M.D.
• Brooke L Deputy, PTA
• Dermatology Associates of Indy LLC

• Nephrology Physician in Evansville, IN
• Providers in Evansville, IN by specialty
• Nephrology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2022; 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.