Individual provider Active NPI

Maryta Marzano, NP

  • Family Nurse Practitioner
  • East Setauket, NY
National Provider Identifier
1306499637
Registry record updated Sep 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
344762 Issued in NY
Practice address
181 N Belle Mead Rd # Suuite2
East Setauket, NY 11733-3495
Phone
(631) 444-6250
Fax
(631) 444-6665
NPI assigned
Jul 16, 2019
Last updated
Sep 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 344762 NY Primary

Addresses

Primary practice location

181 N Belle Mead Rd # Suuite2
East Setauket, NY 11733-3495

Mailing address

181 N Belle Mead Rd Ste 2
East Setauket, NY 11733-3495
Phone (631) 444-6250

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
I20210401000333 NY Practitioner - Nurse Practitioner 4385051796 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-5858

101 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-5858

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Peconic Family Medicine PC CurrentSince Dec 29, 2020 Accepting new patients
Stony Brook Family and Preventive Medicine, University Faculty Practic CurrentSince Nov 17, 2022 Accepting new patients
Paula Montagna, Ms, Rd, CDN, PLLC PastSince Jul 25, 2019 Accepting new patients

Locations

181 N Belle Mead Rd
Ste 2
Setauket, NY 11733
Phone (631) 444-5858

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

Networks

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

Interoperability endpoints

  • Direct secure messaging: maryta.tesoriero@186875407826948.direct.elationemr.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1563235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1306499637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "181 N BELLE MEAD RD STE 2",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117333495",
            "telephone_number": "631-444-6250",
            "fax_number": "631-444-6665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 N BELLE MEAD RD # SUUITE2",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117333495",
            "telephone_number": "631-444-6250",
            "fax_number": "631-444-6665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARZANO",
        "first_name": "MARYTA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-16",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "344762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Setauket, NY

Sources for this page

Verify at the official NPI Registry.