Individual provider Active NPI

Isis V Marrero, M.D.

  • Psychiatry Physician
  • Tampa, FL
National Provider Identifier
1578501862
Registry record updated Mar 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME97375 Issued in FL
Practice address
3515 E Fletcher Ave
Tampa, FL 33613-4706
Phone
(813) 974-8900
NPI assigned
Jun 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 223940 MA
Psychiatry Physician 2084P0800X ME97375 FL Primary

Addresses

Primary practice location

3515 E Fletcher Ave
Tampa, FL 33613-4706

Mailing address

PO Box 917770
Orlando, FL 32891-7770

Other identifiers 2

IdentifierTypeStateIssuer
000576900MedicaidFL
93161OtherFLBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20070808000517 FL Practitioner - Psychiatry 4587755376 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
223940MAMDClinical Social Worker
ME97375FLMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ibis Healthcare Inc CurrentSince Mar 29, 2014 Accepting new patients
Ms & Neuromuscular Center of Excellence LLC CurrentSince Aug 24, 2020 Accepting new patients
University Medical Service Association Inc Current Accepting new patients
Ibis Healthcare Inc CurrentSince Mar 29, 2014 Accepting new patients
University Medical Service Association Inc Psychiatry CurrentSince Nov 5, 2008 Accepting new patients
Tampa General Hospital Current Accepting new patients
University Medical Service Association Inc CurrentSince Nov 5, 2008 Accepting new patients

Locations

5707 N 22nd St
Tampa, FL 33610
Phone (813) 272-2244

12901 Bruce B Downs Blvd
#19
Tampa, FL 33612
Phone (813) 844-4103

3515 E Fletcher Ave
Tampa, FL 33613
Phone (813) 974-2748

12901 Bruce B Downs Blvd
#62
Tampa, FL 33612

3515 E Fletcher Ave
#14
Tampa, FL 33613
Phone (813) 974-8900

Interoperability endpoints

  • Direct secure messaging: imarrero8551@direct.tgh.org
  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 7

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457049600000",
    "number": "1578501862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 917770",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328917770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3515 E FLETCHER AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336134706",
            "telephone_number": "813-974-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARRERO",
        "first_name": "ISIS",
        "middle_name": "V",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2016-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "223940",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME97375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000576900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "93161",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.