Active NPI
Marianne T Fassino, RN
- Rehabilitation Registered Nurse
- Shirley, NY
National Provider Identifier
1588005706
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(2) exclusion effective May 19, 2016.
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Registered Nurse
- License
- 22424986
- Practice address
- 472 Glen Dr
Shirley, NY 11967-1128 - Phone
- (631) 830-2510
- NPI assigned
- Jul 16, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Registered Nurse | 163WR0400X | 22424986 | NY | Primary |
Addresses
Primary practice location
472 Glen Dr
Shirley, NY 11967-1128
Mailing address
472 Glen Dr
Shirley, NY 11967-1128
Phone (631) 830-2510
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22424986 | NY | MD | Rehabilitation Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1373932800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1373932800000",
"number": "1588005706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "472 GLEN DR",
"city": "SHIRLEY",
"state": "NY",
"postal_code": "119671128",
"telephone_number": "631-830-2510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "472 GLEN DR",
"city": "SHIRLEY",
"state": "NY",
"postal_code": "119671128",
"telephone_number": "631-830-2510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FASSINO",
"first_name": "MARIANNE",
"middle_name": "T",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-07-16",
"last_updated": "2013-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "163WR0400X",
"taxonomy_group": "",
"desc": "Registered Nurse, Rehabilitation",
"state": "NY",
"license": "22424986",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shirley, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.