Organization Active NPI

Kerline Marcelin MD,PC

  • Ophthalmology Physician
  • Cortlandt Manor, NY
National Provider Identifier
1407953284
Registry record updated Jul 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
206721 Issued in NY
Legal business name
KERLINE MARCELIN MD,PC
Practice address
1983 Crompond Rd
203
Cortlandt Manor, NY 10567-4121
Phone
(914) 737-6360
Fax
(914) 136-7935
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2010

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

Authorized official

Name
Dr. Kerline Marcelin, MDNPI 1134151749
Title
Chief Officer
Phone
(917) 626-9133

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 206721 NY Primary

Addresses

Primary practice location

1983 Crompond Rd
203
Cortlandt Manor, NY 10567-4121

Mailing address

388 Summit Ave
Mount Vernon, NY 10552-2206
Phone (917) 626-9133

Other identifiers 1

IdentifierTypeStateIssuer
021716608MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101124001044 NY Part B Supplier - Clinic/Group Practice 5193722254 Receives reassigned benefits from 1 practitioner
Practice locations: Cortlandt Manor, NY

National Provider Directory

National Provider Directory

Locations

2050 E Main St
Ste 1R4
Cortlandt Manor, NY 10567
Phone (914) 737-6360

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279843200000",
    "number": "1407953284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "388 SUMMIT AVE",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105522206",
            "telephone_number": "917-626-9133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1983 CROMPOND RD",
            "address_2": "203",
            "city": "CORTLANDT MANOR",
            "state": "NY",
            "postal_code": "105674121",
            "telephone_number": "914-737-6360",
            "fax_number": "914-136-7935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KERLINE MARCELIN MD,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2010-07-23",
        "status": "A",
        "authorized_official_last_name": "MARCELIN",
        "authorized_official_first_name": "KERLINE",
        "authorized_official_title_or_position": "CHIEF OFFICER",
        "authorized_official_telephone_number": "917-626-9133",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "206721",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "021716608",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cortlandt Manor, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.