Individual provider Active NPI

Marina Epelman, MD

  • Pediatric Endocrinology Physician
  • Staten Island, NY
National Provider Identifier
1417361684
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
289291 Issued in NY
Practice address
2460 Hylan Blvd
Staten Island, NY 10306-3117
Phone
(718) 226-5619
NPI assigned
Jun 16, 2014
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Pediatric Endocrinology Physician 2080P0205X 289291 NY Primary

Addresses

Primary practice location

2460 Hylan Blvd
Staten Island, NY 10306-3117

Mailing address

89 Woodcutters LN
Staten Island, NY 10306-6150
Phone (347) 414-0342

Other practice location 1

475 Seaview Ave
Staten Island, NY 10305-3436
Phone (718) 226-9000

Other practice location 2

8622 Bay Pkwy
Brooklyn, NY 11214-4168
Phone (718) 372-8402

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20170830002305 NY Practitioner - Pediatric Medicine 9335412188 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians of University Hospital, PC CurrentSince Jul 1, 2017 Accepting new patients
North Shore-Lij Medical PC CurrentSince May 1, 2019 Accepting new patients
Physicians of University Hospital, PC Pediatric Endocrinology CurrentSince Jul 1, 2017 Accepting new patients

Locations

300 Community Dr
Manhasset, NY 11030

1 Edgewater St
Fl 6
Staten Island, NY 10305
Phone (718) 226-1047

242 Mason Ave
Staten Island, NY 10305
Phone (718) 226-1458

2460 Hylan Blvd
Staten Island, NY 10306
Phone (718) 226-5619

401 Seaview Ave
Lowr
Staten Island, NY 10305
Phone (718) 226-6186

475 Seaview Ave
Staten Island, NY 10305
Phone (718) 226-8855

972 Brush Hollow Rd
Westbury, NY 11590

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: mepelman65387@northwell.direct-ci.com

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": "1402876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1417361684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 WOODCUTTERS LN",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103066150",
            "telephone_number": "347-414-0342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2460 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103063117",
            "telephone_number": "718-226-5619"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "475 Seaview Ave",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103053436",
            "country_code": "US",
            "telephone_number": "718-226-9000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8622 Bay Pkwy",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112144168",
            "country_code": "US",
            "telephone_number": "718-372-8402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EPELMAN",
        "first_name": "MARINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-16",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "NY",
            "license": "289291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.