Active NPI
Marjorie Kanyusik, M.D.
- Hospitalist Physician
- Wallingford, CT
National Provider Identifier
1699705749
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- 039926
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 039926 | CT | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gaylord Hospital, Inc. | Current | 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.
-
- Long Term Care Hospital
- Wallingford, CT
- NPI 1730137753
-
- Internal Medicine Physician
- Bridgeport, CT
- NPI 1043278351
-
- Anesthesiology Physician
- New Haven, CT
- NPI 1205822236
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.