Individual provider Active NPI

Patricia D Marsalisi, CRNA

  • Certified Registered Nurse Anesthetist
  • Suffern, NY
National Provider Identifier
1649308875
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
199915 Issued in NY
Practice address
133 Lafayette Ave
Suffern, NY 10901-5614
Phone
(845) 357-5770
Fax
(845) 357-8263
NPI assigned
Mar 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 199915 NY Primary

Addresses

Primary practice location

133 Lafayette Ave
Suffern, NY 10901-5614

Mailing address

301 Parkside Dr
Suffern, NY 10901-7810
Phone (845) 369-3063

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)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
034976NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Port Jervis Anesthesiology Associates, PLLC 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649308875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 PARKSIDE DR",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109017810",
            "telephone_number": "845-369-3063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 LAFAYETTE AVE",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109015614",
            "telephone_number": "845-357-5770",
            "fax_number": "845-357-8263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSALISI",
        "first_name": "PATRICIA",
        "middle_name": "D",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "199915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffern, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.