Individual provider Active NPI

Marina Carmela Prince, NP

  • Family Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1437982352
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
354444 Issued in NY
Practice address
301 Prospect Ave
Syracuse, NY 13203-1899
Phone
(315) 448-5111
NPI assigned
Aug 26, 2024
Last updated
Feb 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X F354444-01 NY
Family Nurse Practitioner 363LF0000X 354444 NY Primary

Addresses

Primary practice location

301 Prospect Ave
Syracuse, NY 13203-1899

Mailing address

110 Forest View LN
Minoa, NY 13116-1937
Phone (607) 591-3031

Other names 1

  • Marina Pizzola Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241022002695 NY Practitioner - Nurse Practitioner 6406388958 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

301 Prospect Ave
Syracuse, NY 13203-1807
Phone (315) 448-5111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F354444-01NYMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Medical Associates New York PC CurrentSince Oct 15, 2024 Accepting new patients
Physicians Medical Associates New York PC CurrentSince Oct 15, 2024 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

301 Prospect Ave
Syracuse, NY 13203
Phone (315) 448-5111

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": "1724630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1437982352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 FOREST VIEW LN",
            "city": "MINOA",
            "state": "NY",
            "postal_code": "131161937",
            "telephone_number": "607-591-3031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 PROSPECT AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132031899",
            "telephone_number": "315-448-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRINCE",
        "first_name": "MARINA",
        "middle_name": "CARMELA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-26",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "NY",
            "license": "F354444-01",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "354444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARINA",
            "last_name": "PIZZOLA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.