Individual provider Active NPI

Ronald Vincent Marino, D.O.

  • Pediatrics Physician
  • Mineola, NY
National Provider Identifier
1528082575
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
165285 Issued in NY
Practice address
222 Station PLZ N
Suite 611
Mineola, NY 11501-3808
Phone
(516) 663-2532
Fax
(516) 663-2233
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

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 165285 NY Primary

Addresses

Primary practice location

222 Station PLZ N
Suite 611
Mineola, NY 11501-3808

Mailing address

222 Station PLZ N
Suite 611
Mineola, NY 11501-3808
Phone (516) 663-2532

Other identifiers 1

IdentifierTypeStateIssuer
00944207MedicaidNY

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
I20110407000888 NY Practitioner - Pediatric Medicine 6709060254 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Oct 1, 2018 Accepting new patients
New York University Pediatrics CurrentSince Oct 1, 2018 Accepting new patients

Locations

340 W Park Ave
Long Beach, NY 11561
Phone (516) 431-5064

222 Station Plz N
Ste 611
Mineola, NY 11501
Phone (516) 663-2532

Organizations & group practices 2

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528082575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 STATION PLZ N",
            "address_2": "SUITE 611",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115013808",
            "telephone_number": "516-663-2532",
            "fax_number": "516-663-2233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 STATION PLZ N",
            "address_2": "SUITE 611",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115013808",
            "telephone_number": "516-663-2532",
            "fax_number": "516-663-2233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINO",
        "first_name": "RONALD",
        "middle_name": "VINCENT",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "165285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00944207",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mineola, NY

Sources for this page

Verify at the official NPI Registry.