Individual provider Active NPI

Karla-Marie Marcelle

  • Adult Psychiatric/Mental Health Registered Nurse
  • Brooklyn, NY
National Provider Identifier
1538794995
Registry record updated Mar 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X
License
764989 Issued in NY
Practice address
19 Duryea PL
Brooklyn, NY 11226-5426
Phone
(718) 284-3088
NPI assigned
Mar 5, 2020
Last updated
Mar 5, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X 764989 NY Primary

Addresses

Primary practice location

19 Duryea PL
Brooklyn, NY 11226-5426

Mailing address

1050 Dekalb Ave
Brooklyn, NY 11221-2364
Phone (347) 694-9133

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL N/A Direct

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
764989NYMDAdult Psychiatric/Mental Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1583366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583366400000",
    "number": "1538794995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 DEKALB AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112212364",
            "telephone_number": "347-694-9133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 DURYEA PL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112265426",
            "telephone_number": "718-284-3088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCELLE",
        "first_name": "KARLA-MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-05",
        "last_updated": "2020-03-05",
        "certification_date": "2020-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "NY",
            "license": "764989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "19 Duryea Pl",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112265426",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2020; 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.