Individual provider Active NPI

Marian Gambrell, MD

  • Emergency Medicine Physician
  • New York, NY
National Provider Identifier
1720151095
Registry record updated Jun 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
201897 Issued in NY
Practice address
1000 10TH Ave
New York, NY 10019-1147
Phone
(212) 523-6745
NPI assigned
Nov 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 201897 NY Primary

Addresses

Primary practice location

1000 10TH Ave
New York, NY 10019-1147

Mailing address

407 Airport Executive Park
Nanuet, NY 10954-5288

Other identifiers 1

IdentifierTypeStateIssuer
01689330MedicaidNY

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
I20080125000280 NY Practitioner - Emergency Medicine 4587646310 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Temple University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1111 Amsterdam Ave
New York, NY 10025-1716
Phone (212) 987-3100

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Emergency Medicine CurrentSince Nov 1, 2021 Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Fpa Hospital Based Current Accepting new patients
Icahn School of Medicine at Mount Sinai Emergency Medicine CurrentSince Sep 1, 2023 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Sep 1, 2023 Accepting new patients
Phelps Memorial Hospital Association Emergency Medicine Past Accepting new patients
St Lukes Roosevelt Hospital Center Emergency Medicine Past Accepting new patients
Montefiore Medical Center Emergency Medicine Past Accepting new patients
Phelps Memorial Hospital Association Past Accepting new patients

Locations

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

1176 5th Ave
New York, NY 10029
Phone (212) 241-6237

638 Columbus Ave
New York, NY 10024
Phone (212) 523-8672

5 E 98th St
New York, NY 10029
Phone (212) 241-3986

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

1111 Amsterdam Ave
New York, NY 10025
Phone (212) 523-2309

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

701 N Broadway
Sleepy Hollow, NY 10591
Phone (914) 366-3140

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Organizations & group practices 9

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 2

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": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213920000000",
    "number": "1720151095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 AIRPORT EXECUTIVE PARK",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "109545288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 10TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191147",
            "telephone_number": "212-523-6745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBRELL",
        "first_name": "MARIAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2008-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "201897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01689330",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.