Individual provider Active NPI

Cheryl I Marks, NP

  • Family Nurse Practitioner
  • Newton, MA
National Provider Identifier
1366584351
Registry record updated Nov 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
151948 Issued in MA
Practice address
2014 Washington Street
Newton Wellesley Hospital 4 South
Newton, MA 02462
Phone
(617) 243-6142
Fax
(617) 243-6078
NPI assigned
Feb 13, 2007
Last updated
Nov 7, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2008

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 151948 MA Primary

Addresses

Primary practice location

2014 Washington Street
Newton Wellesley Hospital 4 South
Newton, MA 02462

Mailing address

2014 Washington Street Newton Wellesley Hospital
4 South Pain Management
Newton, MA 02462
Phone (617) 243-6142

Other identifiers 2

IdentifierTypeStateIssuer
NP 3091OtherMABLUE CROSS
NP 3091MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20080819000227 MA Practitioner - Nurse Practitioner 5395810816 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospice of the Good Shepherd, Inc.Group PAC ID 8325099351, 7 clinicians

Practice addresses (Care Compare)

160 Wells Ave
Newton, MA 02459-3302
Phone (617) 969-6130

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
151948MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hospice of the Good Shepherd, Inc. CurrentSince Sep 6, 2022 Accepting new patients

Locations

160 Wells Ave
Newton Center, MA 02459
Phone (617) 969-6130

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

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226016000000",
    "number": "1366584351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2014 WASHINGTON STREET NEWTON WELLESLEY HOSPITAL",
            "address_2": "4 SOUTH PAIN MANAGEMENT",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "02462",
            "telephone_number": "617-243-6142",
            "fax_number": "617-243-6078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2014 WASHINGTON STREET",
            "address_2": "NEWTON WELLESLEY HOSPITAL 4 SOUTH",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "02462",
            "telephone_number": "617-243-6142",
            "fax_number": "617-243-6078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKS",
        "first_name": "CHERYL",
        "middle_name": "I",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2008-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "151948",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "NP 3091",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP 3091",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, MA

Sources for this page

Verify at the official NPI Registry.