Active NPI
Mary Ellen Marino, DOM,N.D.
- Acupuncturist
- Santa Fe, NM
National Provider Identifier
1699832048
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 346
- Practice address
- 1925 Aspen Dr
302 B
Santa Fe, NM 87505-5459 - Phone
- (505) 455-0005
- NPI assigned
- Jan 3, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 346 | NM | Primary |
Addresses
Primary practice location
1925 Aspen Dr
302 B
Santa Fe, NM 87505-5459
Mailing address
RT 5 Box 279a
Santa Fe, NM 87506
Phone (505) 455-0005
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NMOOR434 | Other | NM | BLUE CROSS BLUE SHEILD |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 346 | NM | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1699832048",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "RT 5 BOX 279A",
"city": "SANTA FE",
"state": "NM",
"postal_code": "87506",
"telephone_number": "505-455-0005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1925 ASPEN DR",
"address_2": "302 B",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875055459",
"telephone_number": "505-455-0005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARINO",
"first_name": "MARY ELLEN",
"name_prefix": "Dr.",
"credential": "DOM,N.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "NM",
"license": "346",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHEILD",
"identifier": "NMOOR434",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Santa Fe, NM
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.