Marilyn MK Nelson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

D0065518 Issued in MD

Practice address

1302 E Main St
Endicott, NY 13760-5430

Phone

(607) 754-2323

Fax

(607) 754-1846

NPI assigned

Jul 21, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• United Health Services Hospitals, Inc.

  • Multi-Specialty Clinic/Center
  • Johnson City, NY
  • NPI 1962463851
  Medicare reassignment NPD
• United Medical Associates PC

  • Clinic/Center
  • Binghamton, NY
  • NPI 1013972801
  NPD (past)
• Central Vermont Medical Center Inc

  • Family Medicine Physician
  • Berlin, VT
  • NPI 1023028784
  NPD (past)
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550448000000",
    "number": "1497776173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 LEWIS RD",
            "address_2": "2ND FL",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "13905",
            "telephone_number": "607-729-8156",
            "fax_number": "607-729-3982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 E MAIN ST",
            "city": "ENDICOTT",
            "state": "NY",
            "postal_code": "137605430",
            "telephone_number": "607-754-2323",
            "fax_number": "607-754-1846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "MARILYN",
        "middle_name": "MK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2019-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0065518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "482501200",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0035061003",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007288800",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Paul Murphy, PT, DPT
• Theresa Kelly Murphy
• Greta L. Myers, PH.D.
• Sheena Myers
• Kathleen Adams Nedbalski, RN
• Jessica Marie Netherton, LCSW
• Newhorizoneyewearllc
• Nexentra Inc
• North Endicott Chiropractic
• North Endicott Chiropractic PC

• Family Medicine Physician in Endicott, NY
• Providers in Endicott, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.