Active NPI
Gerard Jude Marciano, R.P.A.-C.
- Surgical Physician Assistant
- Flushing, NY
National Provider Identifier
1346518941
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 002671-1
- Practice address
- 5842 Main St
Flushing, NY 11355-5336 - Phone
- (718) 353-3710
- NPI assigned
- Dec 9, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 002671-1 | NY | Primary |
Addresses
Primary practice location
5842 Main St
Flushing, NY 11355-5336
Mailing address
5842 Main St
Flushing, NY 11355-5336
Phone (718) 353-3710
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002671-1 | NY | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323388800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323388800000",
"number": "1346518941",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5842 MAIN ST",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113555336",
"telephone_number": "718-353-3710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5842 MAIN ST",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113555336",
"telephone_number": "718-353-3710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARCIANO",
"first_name": "GERARD",
"middle_name": "JUDE",
"name_prefix": "Mr.",
"credential": "R.P.A.-C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-12-09",
"last_updated": "2011-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "NY",
"license": "002671-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flushing, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.