Individual provider Active NPI

R Anthony Marrese, MD

  • Orthopaedic Surgery Physician
  • Evansville, IN
National Provider Identifier
1750477097
Registry record updated Mar 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
01024696 Issued in IN
Practice address
350 W Columbia St
Suite 230
Evansville, IN 47710
Phone
(812) 424-3321
Fax
(812) 424-3328
NPI assigned
Oct 5, 2006
Last updated
Mar 4, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2008

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 01024696 IN Primary
Orthopaedic Surgery Physician 207X00000X IL
Orthopaedic Surgery Physician 207X00000X 111766 MO
Orthopaedic Surgery Physician 207X00000X ME13714 FL

Addresses

Primary practice location

350 W Columbia St
Suite 230
Evansville, IN 47710

Mailing address

350 W Columbia St
Suite 230
Evansville, IN 47710
Phone (812) 424-3321

Other identifiers 4

IdentifierTypeStateIssuer
0164366043MedicaidIL
211805OtherILMEDICARE
06022530OtherILBCBS
0164366043OtherILIPA

Other names 1

  • Rocco Anthony Marrese Professional name

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

LicenseStateTypeSpecialty
ME13714FLMDOrthopaedic Surgery Physician
036041378ILMDOrthopaedic Surgery Physician
01024696INMDOrthopaedic Surgery Physician
111766MOMDOrthopaedic Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204588800000",
    "number": "1750477097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 W COLUMBIA ST",
            "address_2": "SUITE 230",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "47710",
            "telephone_number": "812-424-3321",
            "fax_number": "812-424-3328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 W COLUMBIA ST",
            "address_2": "SUITE 230",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "47710",
            "telephone_number": "812-424-3321",
            "fax_number": "812-424-3328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARRESE",
        "first_name": "R",
        "middle_name": "ANTHONY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2008-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IN",
            "license": "01024696",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MO",
            "license": "111766",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "ME13714",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0164366043",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "211805",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "06022530",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IPA",
            "identifier": "0164366043",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROCCO",
            "last_name": "MARRESE",
            "middle_name": "ANTHONY",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.