Active NPI
Joseph N Marino, DMD
- Dentist
- Brewster, NY
National Provider Identifier
1609904457
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 044258
- Practice address
- 612 Clock Tower Commons
Brewster, NY 10509-4064 - Phone
- (845) 940-1000
- Fax
- (845) 940-0199
- NPI assigned
- Mar 2, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 044258 | NY | Primary |
Addresses
Primary practice location
612 Clock Tower Commons
Brewster, NY 10509-4064
Mailing address
37 Crosby Rd
North Salem, NY 10560-1043
Phone (914) 276-2805
Medicare participation
Medicare enrollment files- 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: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150519000936 | NY | Order and Referring Only - Oral Surgery | 5395065189 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609904457",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "37 CROSBY RD",
"city": "NORTH SALEM",
"state": "NY",
"postal_code": "105601043",
"telephone_number": "914-276-2805"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "612 CLOCK TOWER COMMONS",
"city": "BREWSTER",
"state": "NY",
"postal_code": "105094064",
"telephone_number": "845-940-1000",
"fax_number": "845-940-0199"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARINO",
"first_name": "JOSEPH",
"middle_name": "N",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "044258",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brewster, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.