Individual provider Active NPI

Marina Doyle, MD

  • Psychiatry Physician
  • Paramus, NJ
National Provider Identifier
1619048238
Registry record updated Jun 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
206802 Issued in NJ
Practice address
11 Mackay Ave
Paramus, NJ 07652-1273
Phone
(201) 587-0380
Fax
(201) 587-0384
NPI assigned
Nov 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 206802 NY
Psychiatry Physician 2084P0800X 206802 NJ Primary

Addresses

Primary practice location

11 Mackay Ave
Paramus, NJ 07652-1273

Mailing address

441 Stonetown Rd
Ringwood, NJ 07456-1310
Phone (201) 289-2930

Other names 1

  • Dr. Marina N Metelitsin Former name

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230719001604 NY Order and Referring Only - PsychiatryPractitioner - Psychiatry 8921199233

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
206802NJMDPsychiatry Physician
206802NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pain Medicine and Anesthesia PC PastSince Jun 1, 2013 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1619048238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 STONETOWN RD",
            "city": "RINGWOOD",
            "state": "NJ",
            "postal_code": "074561310",
            "telephone_number": "201-289-2930",
            "fax_number": "319-253-6128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 MACKAY AVE",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076521273",
            "telephone_number": "201-587-0380",
            "fax_number": "201-587-0384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOYLE",
        "first_name": "MARINA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "206802",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "206802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARINA",
            "last_name": "METELITSIN",
            "middle_name": "N",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Paramus, NJ

Sources for this page

Verify at the official NPI Registry.