Individual provider Active NPI

Casandra Arevalo-Marcano, M.D.

  • Pediatric Pulmonology Physician
  • Morgantown, WV
National Provider Identifier
1417206509
Registry record updated Apr 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
28652 Issued in WV
Practice address
1 Medical Center Dr
Morgantown, WV 26506-1200
Phone
(304) 598-4800
NPI assigned
Sep 5, 2012
Last updated
Apr 13, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MT202639 PA
Pediatric Pulmonology Physician 2080P0214X 28652 WV Primary

Addresses

Primary practice location

1 Medical Center Dr
Morgantown, WV 26506-1200

Mailing address

1 Medical Center Dr
Morgantown, WV 26506-1200
Phone (304) 598-4800

Other practice location 1

5501 Old York Road
Philadelphia, PA 19141
Phone (215) 456-7595

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address cmarcano128511@direct.wvuhsdirect.com Health Information Exchange (HIE)
Direct Messaging Address cmarcano128511@direct.wvuhsdirect.com Health Information Exchange (HIE)
Direct Messaging Address cmarcano128511@direct.wvuhsdirect.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20190211003072 WV Practitioner - Pediatric Medicine 8426396771 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT202639PAMDPediatrics Physician
28652WVMDPediatric Pulmonology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia University Medical Corporation CurrentSince Dec 4, 2018 Accepting new patients
West Virginia University Medical Corporation Pediatrics CurrentSince Dec 4, 2018 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

Organizations & group practices 3

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": "1346803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649808000000",
    "number": "1417206509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265061200",
            "telephone_number": "304-598-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265061200",
            "telephone_number": "304-598-4800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5501 Old York Road",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "19141",
            "country_code": "US",
            "telephone_number": "215-456-7595",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AREVALO-MARCANO",
        "first_name": "CASANDRA",
        "name_prefix": "Miss",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-05",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MT202639",
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "WV",
            "license": "28652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmarcano128511@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1 Medical Center Dr",
            "city": "Morgantown",
            "state": "WV",
            "country_code": "US",
            "postal_code": "265061200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmarcano128511@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1 Medical Center Dr",
            "city": "Morgantown",
            "state": "WV",
            "country_code": "US",
            "postal_code": "265061200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmarcano128511@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1 Medical Center Dr",
            "city": "Morgantown",
            "state": "WV",
            "country_code": "US",
            "postal_code": "265061200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

Verify at the official NPI Registry.