Individual provider Active NPI

Marylene Duah, M.D.

  • Infectious Disease Physician
  • Watertown, NY
National Provider Identifier
1700835337
Registry record updated May 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
224086 Issued in NY
Practice address
1575 Washington St
Watertown, NY 13601-9367
Phone
(315) 786-7300
Fax
(315) 786-7310
NPI assigned
May 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 224086 NY Primary

Addresses

Primary practice location

1575 Washington St
Watertown, NY 13601-9367

Mailing address

1575 Washington St
Watertown, NY 13601-9367
Phone (315) 786-7300

Other identifiers 1

IdentifierTypeStateIssuer
00354316MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040419000931 NY Practitioner - Internal MedicinePractitioner - Infectious Disease 0244225233 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Infectious Disease
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Samaritan Medical CenterGroup PAC ID 8123914876, 157 clinicians

Practice addresses (Care Compare)

1575 Washington St
Watertown, NY 13601-9371
Phone (315) 779-5060

Hospital & facility affiliations

  • Samaritan Medical Center Hospital, Watertown, NY, CCN 330157

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
001155NYMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Edward John Noble Hospital of Gouverneur Ny Past Accepting new patients
Edward John Noble Hospital of Gouverneur Ny Swing Bed Unit Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: marylene.duah@sfhcny.eclinicaldirectplus.com

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304294400000",
    "number": "1700835337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1575 WASHINGTON ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136019367",
            "telephone_number": "315-786-7300",
            "fax_number": "315-786-7310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 WASHINGTON ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136019367",
            "telephone_number": "315-786-7300",
            "fax_number": "315-786-7310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUAH",
        "first_name": "MARYLENE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2011-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NY",
            "license": "224086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00354316",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

Verify at the official NPI Registry.