Individual provider Active NPI

Marilyn Grace Marencik, FNP-C

  • Family Nurse Practitioner
  • Radnor, PA
National Provider Identifier
1578088712
Registry record updated Jul 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP017705 Issued in PA
Practice address
250 King of Prussia Rd
Radnor, PA 19087-5235
Phone
(215) 662-7366
NPI assigned
Aug 9, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP017705 PA Primary

Addresses

Primary practice location

250 King of Prussia Rd
Radnor, PA 19087-5235

Mailing address

250 King of Prussia Rd
Radnor, PA 19087-5227
Phone (610) 902-2450

Other practice location 1

1001 Chesterbrook Blvd
Berwyn, PA 19312-3805
Phone (610) 576-7500

Other names 1

  • Marilyn Grace Purvis Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191122000765 PA Practitioner - Nurse Practitioner 5890127203 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

3400 Civic Ctr Blvd
Philadelphia, PA 19104-5127

3400 Civic Ctr Blvd 2ND FLR W
Advanced Internal Med
Philadelphia, PA 19104-5127
Phone (215) 615-5252

3801 Filbert St Mab
102 Penn Center for Primary Care
Philadelphia, PA 19104-2640
Phone (215) 662-9990

51 N 39TH St
Philadelphia, PA 19104-2640
Phone (215) 662-9436

51 N 39TH Street Mab
Philadelphia, PA 19104-2640
Phone (215) 662-9990

51 N 39TH Stret
Hospital Med Presby
Philadelphia, PA 19104-2640
Phone (215) 662-9990

Hospital & facility affiliations

  • Chester County Hospital Hospital, West Chester, PA, CCN 390179
  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Sep 25, 2019 Accepting new patients
University of Penn - Medical Group CurrentSince Mar 31, 2024 Accepting new patients
University of Penn-Medical Group CurrentSince Mar 31, 2024 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Current Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Syst CurrentSince Sep 25, 2019 Accepting new patients

Locations

1001 Chesterbrook Blvd
Berwyn, PA 19312
Phone (610) 576-7500

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

250 King of Prussia Rd
Radnor, PA 19087
Phone (610) 902-1800

250 King of Prussia Rd
Ste 2J
Radnor, PA 19087
Phone (610) 902-2450

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

Organizations & group practices 5

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1502236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1578088712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 KING OF PRUSSIA RD",
            "city": "RADNOR",
            "state": "PA",
            "postal_code": "190875227",
            "telephone_number": "610-902-2450",
            "fax_number": "610-902-2466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 KING OF PRUSSIA RD",
            "city": "RADNOR",
            "state": "PA",
            "postal_code": "190875235",
            "telephone_number": "215-662-7366"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Chesterbrook Blvd",
            "address_purpose": "LOCATION",
            "city": "Berwyn",
            "state": "PA",
            "postal_code": "193123805",
            "country_code": "US",
            "telephone_number": "610-576-7500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARENCIK",
        "first_name": "MARILYN",
        "middle_name": "GRACE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-09",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP017705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARILYN",
            "last_name": "PURVIS",
            "middle_name": "GRACE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Radnor, PA

Sources for this page

Verify at the official NPI Registry.