Individual provider Active NPI

Mariella Disturco

  • Student in an Organized Health Care Education/Training Program
  • New York, NY
National Provider Identifier
1306208764
Registry record updated Mar 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
100 E 77TH St
New York, NY 10075-1850
Phone
(908) 216-5075
NPI assigned
Mar 24, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2016

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 Primary

Addresses

Primary practice location

100 E 77TH St
New York, NY 10075-1850

Mailing address

316 Cambourne Dr
Toms River, NJ 08753-1903

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20240717000249 NJ Practitioner - Obstetrics/Gynecology 9133464878 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifeline Medical Associates LLCGroup PAC ID 1456332170, 155 clinicians

Practice addresses (Care Compare)

16 Pocono Rd
Suite 309
Denville, NJ 07834-2908
Phone (973) 983-7695

Hospital & facility affiliations

  • Saint Clare'S Hospital/ Denville Campus Hospital, Denville, NJ, CCN 310050
  • Morristown Medical Center Hospital, Morristown, NJ, CCN 310015

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine of Morris County LLC CurrentSince Dec 6, 2024 Accepting new patients
OB Hospitalist Services New Jersey, PA CurrentSince Feb 19, 2025 Accepting new patients
Lifeline Medical Associates, LLC CurrentSince Jul 1, 2024 Accepting new patients

Locations

16 Pocono Rd
Denville, NJ 07834
Phone (973) 625-5651

25 Pocono Rd
Denville, NJ 07834
Phone (273) 625-6000

16 Pocono Rd
Ste 302
Denville, NJ 07834
Phone (973) 627-3411

16 Pocono Rd
Frnt
Denville, NJ 07834
Phone (973) 784-3935

400 W Blackwell St
Dover, NJ 07801
Phone (973) 537-3818

100 Campus Dr
Ste 405
Florham Park, NJ 07932
Phone (800) 845-2785

21 Mohawk Ave
Sparta, NJ 07871
Phone (973) 729-4211

718 Teaneck Rd
Teaneck, NJ 07666
Phone (201) 833-3232

425 Jack Martin Blvd
Wall Township, NJ 08724
Phone (732) 840-2200

Interoperability endpoints

  • Direct secure messaging: mariella.disturco.1@27010.direct.athenahealth.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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 2

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": "1458777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458864000000",
    "number": "1306208764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 CAMBOURNE DR",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087531903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E 77TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100751850",
            "telephone_number": "908-216-5075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISTURCO",
        "first_name": "MARIELLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-24",
        "last_updated": "2016-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.