Marine Petriashvili, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

271189 Issued in NY

Practice address

760 Broadway
Brooklyn, NY 11206-5317

Phone

(718) 963-8496

NPI assigned

Oct 13, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Anesthesiology

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Midtown Medical, PLLCGroup PAC ID 4880870963, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

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

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.

• Midtown Medical, PLLC

  • Anesthesiology Physician
  • New York, NY
  • NPI 1699073007

  Single Specialty

  Medicare reassignment Care Compare group NPD
• New York Medical and Diagnostic Services PC

  • Anatomic Pathology Physician
  • Brooklyn, NY
  • NPI 1639605991

  Single Specialty

  Medicare reassignment NPD
• Triborough Gi PLLC

  • Gastroenterology Physician
  • Brooklyn, NY
  • NPI 1255711339

  Single Specialty

  Medicare reassignment NPD
• Triborough Gi PLLC

  • Clinical Medical Laboratory
  • Brooklyn, NY
  • NPI 1932820339
  NPD
• Agi Medical PLLC

  • Specialist
  • Brooklyn, NY
  • NPI 1730322645

  Single Specialty

  NPD (past)
• Daniel J Alpert, M.D. PLLC

  • Specialist
  • New York, NY
  • NPI 1023247046

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537228800000",
    "number": "1629168448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3531 85TH ST APT 3J",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113725521",
            "telephone_number": "718-803-8509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 BROADWAY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112065317",
            "telephone_number": "718-963-8496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRIASHVILI",
        "first_name": "MARINE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2018-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "271189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephan Petranker, M.D.
• Michael Petratos, R.PH
• Christopher Paul Petrella
• Julian Gabriel Petrello, LCSW, MA
• Dmitri Petriashvili, PTA
• Olivia Rose Petrik
• Megan Anne Petrizio, M.A.-CCC, SLP
• Ann Marie Petrocelli, LMSW
• Danielle L Petrocelli, PHARM.D
• Avi Joshua Petroff, M.D.

• Anesthesiology Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Anesthesiology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.