Active NPI
Marina Doyle, MD
- Psychiatry Physician
- Paramus, NJ
National Provider Identifier
1619048238
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 206802
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230719001604 | NY | Order and Referring Only - Psychiatry | 8921199233 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 206802 | NJ | MD | Psychiatry Physician |
| 206802 | NY | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pain Medicine and Anesthesia PC | Past | 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.
-
- Pain Medicine (Anesthesiology) Physician
- Franklin Lakes, NJ
- NPI 1386925394
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2022; 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.