Irene L Marsidi, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

35-04-9887M Issued in OH

Practice address

120 W Wenger Rd
Englewood, OH 45322

Phone

(937) 836-9921

Fax

(937) 836-1298

NPI assigned

Jan 24, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392336000000",
    "number": "1336119254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W WENGER RD",
            "city": "ENGLEWOOD",
            "state": "OH",
            "postal_code": "45322",
            "telephone_number": "937-836-9921",
            "fax_number": "937-836-1298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 W WENGER RD",
            "city": "ENGLEWOOD",
            "state": "OH",
            "postal_code": "45322",
            "telephone_number": "937-836-9921",
            "fax_number": "937-836-1298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSIDI",
        "first_name": "IRENE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-24",
        "last_updated": "2014-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35-04-9887M",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1220092",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "D49887",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0568149",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000011107",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zarifa I Mamatova
• Mana Home Health Care LLC
• Danika Nicole Mann, LMT
• Maranatha Family Counseling, LLC
• Robert Michael Margolis, M.D.
• Annette Martin
• Massachusetts Lab Inc.
• Erica Mathews, RN
• Brittany Mathias, PA
• Catherine N Mbah, RN

• Pediatrics Physician in Englewood, OH
• Providers in Englewood, OH by specialty
• Pediatrics Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.