Shauntel Nichole Marcin

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71012899A Issued in IN

Practice address

221 Red Coach Dr Ste E
Mishawaka, IN 46545-8324

Phone

(574) 335-7630

NPI assigned

Jun 17, 2022

Last updated

Feb 19, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Saint Joseph Regional Medical Center IncGroup PAC ID 8325950843, 137 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: smarcin1148366@direct.trinity-health.org

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.

• Saint Joseph Regional Medical Center, Inc.

  dba Saint Joseph Medical Group

  • Pulmonary Disease Physician
  • Plymouth, IN
  • NPI 1225082878
  Medicare reassignment Care Compare group NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Terre Haute, IN
  • NPI 1285103671
  Medicare reassignment NPD
• Elite Emergency Physicians Inc

  • Emergency Medicine Physician
  • Elkhart, IN
  • NPI 1932155371
  Medicare reassignment NPD
• Saint Joseph Regional Medical Center- Plymouth Campus Inc

  dba Saint Joseph Foot and Ankle Sports Medicine Institute Plymouth

  • Family Medicine Physician
  • Plymouth, IN
  • NPI 1538585187
  Medicare reassignment NPD
• Saint Joseph Regional Medical Center-South Bend Campus, Inc

  dba Saint Joseph Regional Medical Center-South Bend Campus Inc Mobile Med

  • Mobile Mammography Clinic/Center
  • South Bend, IN
  • NPI 1023844693
  Medicare reassignment NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Mishawaka, IN
  • NPI 1811796006
  NPD
• Saint Joseph Regional Medical Center- Plymouth Campus Inc

  • Hospitalist Physician
  • Plymouth, IN
  • NPI 1821402876
  NPD
• Saint Joseph Regional Medical Center-South Bend Campus, Inc

  • Critical Care Medicine (Internal Medicine) Physician
  • Mishawaka, IN
  • NPI 1699132365
  NPD
• Saint Joseph Regional Medical Center-South Bend Campus, Inc.

  • General Acute Care Hospital
  • Mishawaka, IN
  • NPI 1841245594
  NPD
• Saint Joseph Regional Medical Center, Inc.

  dba Saint Joseph Medical Group

  • Family Medicine Physician
  • Mishawaka, IN
  • NPI 1467406074
  NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Fort Lauderdale, FL
  • NPI 1700747946
  NPD

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

{
    "created_epoch": "1655424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1689305948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 CEDAR ST STE 405",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172059",
            "telephone_number": "574-335-8707",
            "fax_number": "574-335-0741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 RED COACH DR STE E",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465458324",
            "telephone_number": "574-335-7630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCIN",
        "first_name": "SHAUNTEL",
        "middle_name": "NICHOLE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-17",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28219930A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71012899A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "1102613645",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300065789",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeremy Ross Mann
• Trevor David Manspeaker, OTD, OTR
• Kristin A Mar-Elia
• Emily Marcel
• Nicholas James Marchi, M.A., ED.S.
• Legna Ana-Marie Marczewski
• Margaret a Walter MD PC
• Kaley Michelle Marino, APRN, FNP-C
• Marion Vamc
• Marketplace Financial, Incorporated (Accel EMS)

• Family Nurse Practitioner in Mishawaka, IN
• Providers in Mishawaka, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; 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.