Active NPI
Isis V Marrero, M.D.
- Psychiatry Physician
- Tampa, FL
National Provider Identifier
1578501862
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- ME97375
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000576900 | Medicaid | FL | |
| 93161 | Other | FL | BLUE 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 223940 | MA | MD | Clinical Social Worker |
| ME97375 | FL | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ibis Healthcare Inc | Current | Accepting new patients | |
| Ms & Neuromuscular Center of Excellence LLC | Current | Accepting new patients | |
| University Medical Service Association Inc | Current | Accepting new patients | |
| Ibis Healthcare Inc | Current | Accepting new patients | |
| University Medical Service Association Inc | Psychiatry | Current | Accepting new patients |
| Tampa General Hospital | Current | Accepting new patients | |
| University Medical Service Association Inc | Current | 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
- imarrero8551@direct.tgh.org
- 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.
-
- Community/Behavioral Health Agency
- Tampa, FL
- NPI 1346224011
-
- Physical Therapist
- Tampa, FL
- NPI 1992742324
-
- Federally Qualified Health Center (FQHC)
- Tampa, FL
- NPI 1922777218
-
- Neurology Physician
- Clearwater, FL
- NPI 1821480419
-
- General Acute Care Hospital
- Tampa, FL
- NPI 1124558929
-
- Durable Medical Equipment & Medical Supplies
- Tampa, FL
- NPI 1194276576
-
- Psychiatry Physician
- Tampa, FL
- NPI 1205876125
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.