Individual provider Active NPI

Manuel Marquez, FNP

  • Family Nurse Practitioner
  • Fairfield, CT
National Provider Identifier
1740532977
Registry record updated Mar 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F337207-1 Issued in NY
Practice address
75 Kings Highway Cutoff Ste 3a
Fairfield, CT 06824-5340
Phone
(203) 373-7330
NPI assigned
Oct 11, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F337207-1 NY Primary

Addresses

Primary practice location

75 Kings Highway Cutoff Ste 3a
Fairfield, CT 06824-5340

Mailing address

11350 McCormick Rd
Executive Plaza 1, Ste. 501
Hunt Valley, MD 21031-2313
Phone (703) 914-8000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mmarquez@nspc.emadirect.md

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130607000257 NY Practitioner - Nurse Practitioner 0749428472 Reassigns benefits to 1 organization
I20210308000578 CT Practitioner - Nurse Practitioner 0749428472 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

67 Sand Pit Rd
Danbury, CT 06810-4032
Phone (203) 792-7277

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
9380CTMDClinical Social Worker
337207NYMDLicensed Practical Nurse
F337207-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pain & Spine Specialists of Connecticut, LLC CurrentSince Jan 4, 2021 Accepting new patients
Pain & Spine Specialists of Connecticut, LLC CurrentSince Jan 4, 2021 Accepting new patients
Bronx Anesthesia Services, PC CurrentSince Mar 18, 2013 Accepting new patients

Locations

67 Sand Pit Rd
Danbury, CT 06810
Phone (203) 792-2003

75 Kings Highway Cutoff
Ste 3A
Fairfield, CT 06824
Phone (203) 373-7330

11 South Rd
Ste 250
Farmington, CT 06032
Phone (860) 674-0222

11350 McCormick Rd
Ste 501
Hunt Valley, MD 21031
Phone (410) 329-1071

4422 3rd Ave
Bronx, NY 10457
Phone (718) 960-3917

Interoperability endpoints

  • Direct secure messaging: mmarquez@hiemail.healtheconnections.org

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": "1349913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1740532977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11350 MCCORMICK RD",
            "address_2": "EXECUTIVE PLAZA 1, STE. 501",
            "city": "HUNT VALLEY",
            "state": "MD",
            "postal_code": "210312313",
            "telephone_number": "703-914-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 KINGS HIGHWAY CUTOFF STE 3A",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068245340",
            "telephone_number": "203-373-7330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARQUEZ",
        "first_name": "MANUEL",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-11",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F337207-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmarquez@nspc.emadirect.md",
            "affiliation": "N",
            "address_1": "75 Kings Highway Cutoff Ste 3A",
            "city": "Fairfield",
            "state": "CT",
            "country_code": "US",
            "postal_code": "068245340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fairfield, CT

Sources for this page

Verify at the official NPI Registry.