Individual provider Active NPI

Marieta K Borres, NP

  • Acute Care Nurse Practitioner
  • New York, NY
National Provider Identifier
1285927806
Registry record updated May 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
F430533-1 Issued in NY
Practice address
564 1St Ave
Apt 17U
New York, NY 10016-6482
Phone
(917) 254-7990
NPI assigned
May 16, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X F430533-1 NY Primary

Addresses

Primary practice location

564 1St Ave
Apt 17U
New York, NY 10016-6482

Mailing address

564 1St Ave
Apt 17U
New York, NY 10016-6482
Phone (917) 254-7990

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181127001978 NY Practitioner - Nurse Practitioner 9335461714 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

530 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

550 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

560 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F430533-1NYMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Oct 15, 2018 Accepting new patients
New York University CurrentSince Oct 15, 2018 Accepting new patients

Locations

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Networks

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

Interoperability endpoints

  • Direct secure messaging: mborres42258@nyumc.direct-ci.com

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.

Hospital & facility affiliations 7

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": "1305504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305504000000",
    "number": "1285927806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "564 1ST AVE",
            "address_2": "APT 17U",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166482",
            "telephone_number": "917-254-7990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "564 1ST AVE",
            "address_2": "APT 17U",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166482",
            "telephone_number": "917-254-7990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORRES",
        "first_name": "MARIETA",
        "middle_name": "K",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-16",
        "last_updated": "2011-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "F430533-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.