Marino A Poliseno, DO

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

225825 Issued in NY

Practice address

1050 Clove Rd
Staten Island, NY 10301-3627

Phone

(718) 442-4300

Fax

(718) 816-8369

NPI assigned

Oct 4, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Specialty

Obstetrics/Gynecology

Education

New York College of Osteo Medicine of New York Institute of Technology, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Amboy Medical Practice PCGroup PAC ID 2860538170, 171 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Richmond University Medical Center Hospital, Staten Island, NY, CCN 330028
• Staten Island University Hospital Hospital, Staten Island, NY, CCN 330160

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722

Interoperability endpoints

• Direct secure messaging: marino.poliseno.1@19656.direct.athenahealth.com

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.

• Amboy Medical Practice PC

  • Internal Medicine Physician
  • Staten Island, NY
  • NPI 1700037975

  Obstetrics & Gynecology

  Medicare reassignment Care Compare group NPD
• Strong Obstetrics-Gynecology Group

  • Obstetrics & Gynecology Physician
  • Rochester, NY
  • NPI 1184668311
  Medicare reassignment NPD
• Amboy Medical Practice PC

  • Diagnostic Radiology Physician
  • Staten Island, NY
  • NPI 1104692672
  NPD
• Richmond Medical Center

  • General Acute Care Hospital
  • Staten Island, NY
  • NPI 1740389154
  NPD (past)
• Richmond University Medical Center

  • Multi-Specialty Clinic/Center
  • Staten Island, NY
  • NPI 1811054042
  NPD (past)

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

• Richmond Medical Center

  • General Acute Care Hospital
  • Staten Island, NY
  • NPI 1740389154
  Care Compare affiliation
• Staten Island University Hospital

  • General Acute Care Hospital
  • Staten Island, NY
  • NPI 1407877137
  Care Compare affiliation

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437004800000",
    "number": "1578550596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 CLOVE RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103013627",
            "telephone_number": "646-680-2888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 CLOVE RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103013627",
            "telephone_number": "718-442-4300",
            "fax_number": "718-816-8369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLISENO",
        "first_name": "MARINO",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2015-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "225825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7166589",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02590985",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0297012",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Subbaraju Polepalli, M.D.
• Deborah S Poleshuck, C.C.C./SLP
• Jacqueline Poli
• Policy Research International Inc
• Jaclyn Polimeni
• Laura Polito, PA-C
• Christine Pollack, OTR/L
• Ebony Imani Pollock, OT
• Boris Polonskiy, DPT
• Tatsiana Polonskiy

• Obstetrics & Gynecology Physician in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Obstetrics & Gynecology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2015; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.