Jimmy Marseille, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

2025067416 Issued in NY

Practice address

21 12TH Ave
Huntington Station, NY 11746-2104

Phone

(631) 988-0848

NPI assigned

Sep 29, 2025

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1759104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1376416966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 12TH AVE",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117462104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 12TH AVE",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117462104",
            "telephone_number": "631-988-0848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSEILLE",
        "first_name": "JIMMY",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-09-29",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NY",
            "license": "779861",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "2025067416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keiry Giselle Manzanares
• Marc Adelberg DDS, PLLC
• Maureen Kelly Marcus, RN
• Tina Marie Marengo
• Marleen Marino, O.D.
• Jessica Marti, CD, CPPD
• Evan Marx, D.P.T.
• Mary Frank LCSW Psychotherapy PLLC
• Diane E Massa, LCSW
• Magdalena Mercedes Massone, SLP

• Psychiatric/Mental Health Nurse Practitioner in Huntington Station, NY
• Providers in Huntington Station, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.