Individual provider Active NPI

Marjorie Kanyusik, M.D.

  • Hospitalist Physician
  • Wallingford, CT
National Provider Identifier
1699705749
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
039926 Issued in CT
Practice address
Gaylord Hospital
Gaylord Farms Road
Wallingford, CT 06492
Phone
(203) 284-2800
Fax
(203) 679-3598
NPI assigned
Jul 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 039926 CT
Hospitalist Physician 208M00000X 039926 CT Primary

Addresses

Primary practice location

Gaylord Hospital
Gaylord Farms Road
Wallingford, CT 06492

Mailing address

PO Box 400
Gaylord Hospital
Wallingford, CT 06492
Phone (203) 284-2800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
039926CTMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gaylord Hospital, Inc. CurrentSince Aug 19, 2004 Accepting new patients
Northeast Medical Group, Inc. Past Accepting new patients
Yale University Past Accepting new patients

Locations

50 Gaylord Farm Rd
Wallingford, CT 06492
Phone (203) 679-3553

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1699705749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 400",
            "address_2": "GAYLORD HOSPITAL",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "06492",
            "telephone_number": "203-284-2800",
            "fax_number": "203-679-3598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "GAYLORD HOSPITAL",
            "address_2": "GAYLORD FARMS ROAD",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "06492",
            "telephone_number": "203-284-2800",
            "fax_number": "203-679-3598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANYUSIK",
        "first_name": "MARJORIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "039926",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CT",
            "license": "039926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wallingford, CT

Sources for this page

Verify at the official NPI Registry.