Individual provider Active NPI

Marie Decius

  • Licensed Practical Nurse
  • Queens Village, NY
National Provider Identifier
1457747339
Registry record updated Apr 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
321388-1 Issued in NY
Practice address
22112 112TH Road
Queens Village, NY 11429
Phone
(347) 254-5218
NPI assigned
Apr 8, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 321388-1 NY Primary

Addresses

Primary practice location

22112 112TH Road
Queens Village, NY 11429

Mailing address

22112 112TH Rd
Queens Village, NY 11429-2605
Phone (347) 254-5218

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
321388-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1428451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428451200000",
    "number": "1457747339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22112 112TH RD",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114292605",
            "telephone_number": "347-254-5218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22112 112TH ROAD",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "11429",
            "telephone_number": "347-254-5218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECIUS",
        "first_name": "MARIE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-08",
        "last_updated": "2015-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "321388-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queens Village, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.