Active NPI
Michael Marrella, M.D.
- Psychiatry Physician
- Uncasville, CT
National Provider Identifier
1750449930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 42802
- Practice address
- 20 Maple Ave
Uncasville, CT 06382-2345 - Phone
- (860) 848-3098
- Fax
- (860) 848-1152
- NPI assigned
- Dec 4, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 42802 | CT | Primary |
Addresses
Primary practice location
20 Maple Ave
Uncasville, CT 06382-2345
Mailing address
20B Doyle Rd
Waterford, CT 06385-1540
Phone (860) 437-1233
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 42802 | CT | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Natchaug Hospital, Inc. | Past | Accepting new patients | |
| Natchaug Hospital | Past | Accepting new patients | |
| Associated Specialists of Southeastern Connecticut, Inc. | Psychiatry | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Internal Medicine Physician
- New London, CT
- NPI 1588844591
Psychiatry
-
- Psychiatric Hospital
- Mansfield Center, CT
- NPI 1295811321
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1750449930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20B DOYLE RD",
"city": "WATERFORD",
"state": "CT",
"postal_code": "063851540",
"telephone_number": "860-437-1233",
"fax_number": "860-848-1152"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 MAPLE AVE",
"city": "UNCASVILLE",
"state": "CT",
"postal_code": "063822345",
"telephone_number": "860-848-3098",
"fax_number": "860-848-1152"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARRELLA",
"first_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CT",
"license": "42802",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Uncasville, CT
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.