Mariel Brooke Deutsch, MD, FAAN

Primary specialty

Behavioral Neurology & Neuropsychiatry PhysicianTaxonomy code 2084B0040X

License

264163 Issued in NY

Practice address

1955 Merrick Rd Ste 204
Merrick, NY 11566-4635

Phone

(516) 636-3873

Fax

(516) 210-2616

NPI assigned

Jun 11, 2008

Last updated

Feb 16, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other names 1

• Mariel Fisher Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 18, 2022 through Jul 18, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: marieldeutsch@nslijmedgr.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Neurology Mind Care PLLC

  • Behavioral Neurology & Neuropsychiatry Physician
  • Merrick, NY
  • NPI 1497479794
  NPD Authorized official

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

{
    "created_epoch": "1213142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1578723854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1955 MERRICK RD STE 204",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115664635",
            "telephone_number": "516-636-3873",
            "fax_number": "516-210-2616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1955 MERRICK RD STE 204",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115664635",
            "telephone_number": "516-636-3873",
            "fax_number": "516-210-2616"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "611 Northern Blvd Ste 150",
            "address_purpose": "LOCATION",
            "city": "Great Neck",
            "state": "NY",
            "postal_code": "11021",
            "country_code": "US",
            "telephone_number": "516-325-7000",
            "fax_number": "516-325-7001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Gustave L Levy Pl",
            "address_2": "Neurology - Box 1137",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100296504",
            "country_code": "US",
            "telephone_number": "212-241-7076",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "27005 76th Ave",
            "address_purpose": "LOCATION",
            "city": "New Hyde Park",
            "state": "NY",
            "postal_code": "110401402",
            "country_code": "US",
            "telephone_number": "000-000-0000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Community Dr",
            "address_purpose": "LOCATION",
            "city": "Manhasset",
            "state": "NY",
            "postal_code": "110303816",
            "country_code": "US",
            "telephone_number": "000-000-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEUTSCH",
        "first_name": "MARIEL",
        "middle_name": "BROOKE",
        "name_prefix": "Dr.",
        "credential": "MD, FAAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-11",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "264163",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A124659",
            "primary": false
        },
        {
            "code": "2084B0040X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
            "state": "NY",
            "license": "264163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIEL",
            "last_name": "FISHER",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Behavioral Neurology & Neuropsychiatry Physician in Merrick, NY
• Providers in Merrick, NY by specialty
• Behavioral Neurology & Neuropsychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2023; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.