Individual provider Active NPI

Marie Ann Marino, RN, PNP

  • Pediatric Nurse Practitioner
  • Saint James, NY
National Provider Identifier
1659506236
Registry record updated May 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
380408 Issued in NY
Practice address
4 Tusa CT
Saint James, NY 11780-1624
Phone
(631) 979-0481
NPI assigned
May 26, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 380408 NY Primary

Addresses

Primary practice location

4 Tusa CT
Saint James, NY 11780-1624

Mailing address

4 Tusa CT
Saint James, NY 11780-1624
Phone (631) 979-0481

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
380408NYMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1243296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243296000000",
    "number": "1659506236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 TUSA CT",
            "city": "SAINT JAMES",
            "state": "NY",
            "postal_code": "117801624",
            "telephone_number": "631-979-0481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 TUSA CT",
            "city": "SAINT JAMES",
            "state": "NY",
            "postal_code": "117801624",
            "telephone_number": "631-979-0481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINO",
        "first_name": "MARIE ANN",
        "credential": "RN, PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-26",
        "last_updated": "2009-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "380408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint James, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2009; 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.