Individual provider Active NPI

Belinda Agharese Marquis, MD

  • Pediatrics Physician
  • Wyandanch, NY
National Provider Identifier
1508827080
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
166813 Issued in NY
Practice address
1543 Straight Path
Wyandanch, NY 11798-3415
Phone
(631) 643-6006
Fax
(631) 643-7026
NPI assigned
Mar 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 166813 NY Primary

Addresses

Primary practice location

1543 Straight Path
Wyandanch, NY 11798-3415

Mailing address

1543 Straight Path
Wyandanch, NY 11798-3415
Phone (631) 643-6006

Other identifiers 1

IdentifierTypeStateIssuer
01004764MedicaidNY

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
I20110428000189 NY Practitioner - Pediatric Medicine 5597940940 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Children's Service, University Faculty Practice Corporatio Pediatrics CurrentSince Jan 2, 2024 Accepting new patients

Locations

2701 Sunrise Hwy
Islip Terrace, NY 11752
Phone (631) 444-6300

1543 Straight Path
Wyandanch, NY 11798
Phone (631) 643-6006

Networks

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

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508827080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1543 STRAIGHT PATH",
            "city": "WYANDANCH",
            "state": "NY",
            "postal_code": "117983415",
            "telephone_number": "631-643-6006",
            "fax_number": "631-643-7026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1543 STRAIGHT PATH",
            "city": "WYANDANCH",
            "state": "NY",
            "postal_code": "117983415",
            "telephone_number": "631-643-6006",
            "fax_number": "631-643-7026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARQUIS",
        "first_name": "BELINDA",
        "middle_name": "AGHARESE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "166813",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01004764",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyandanch, NY

Sources for this page

Verify at the official NPI Registry.