Individual provider Active NPI

Bernard V. Marzilli, Jr., D.O.

  • Family Medicine Physician
  • Westerly, RI
National Provider Identifier
1396825931
Registry record updated Jun 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO-329 Issued in RI
Practice address
60 Wells St
Westerly, RI 02891-2924
Phone
(401) 596-6400
NPI assigned
Oct 17, 2006
Last updated
Jun 15, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO-329 RI Primary

Addresses

Primary practice location

60 Wells St
Westerly, RI 02891-2924

Mailing address

60 Wells St
Westerly, RI 02891-2924
Phone (401) 596-6400

Other identifiers 1

IdentifierTypeStateIssuer
9003029MedicaidRI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100908000710 RI Practitioner - Family Practice 8729103122 Practice locations: Westerly, RI

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of New England, College of Osteo Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

60 Wells St
Westerly, RI 02891-2924
Phone (401) 596-6400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO-329RIMDFamily Medicine Physician

Hospital & facility affiliations 1

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276560000000",
    "number": "1396825931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 WELLS ST",
            "city": "WESTERLY",
            "state": "RI",
            "postal_code": "028912924",
            "telephone_number": "401-596-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 WELLS ST",
            "city": "WESTERLY",
            "state": "RI",
            "postal_code": "028912924",
            "telephone_number": "401-596-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARZILLI, JR.",
        "first_name": "BERNARD",
        "middle_name": "V.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2010-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "RI",
            "license": "DO-329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9003029",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westerly, RI

Sources for this page

Verify at the official NPI Registry.