Organization Active NPI

Marin Medical Services, PLLC

  • Physical Medicine & Rehabilitation Physician
  • Smithtown, NY
National Provider Identifier
1790988533
Registry record updated Aug 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
131675 Issued in NY
Legal business name
MARIN MEDICAL SERVICES, PLLC
Practice address
285 Middle Country Rd
Suite LL-5
Smithtown, NY 11787-2980
Phone
(631) 265-6717
Fax
(631) 265-6714
NPI assigned
Jun 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2014

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

Authorized official

Name
Edgar L. Marin, M.D.NPI 1295893295
Title
Sole Owner
Phone
(631) 265-6717

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X 131675 NY Primary

Addresses

Primary practice location

285 Middle Country Rd
Suite LL-5
Smithtown, NY 11787-2980

Mailing address

285 Middle Country Rd
Suite LL-5
Smithtown, NY 11787-2980
Phone (631) 265-6717

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1181260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408665600000",
    "number": "1790988533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 MIDDLE COUNTRY RD",
            "address_2": "SUITE LL-5",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872980",
            "telephone_number": "631-265-6717",
            "fax_number": "631-265-6714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 MIDDLE COUNTRY RD",
            "address_2": "SUITE LL-5",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872980",
            "telephone_number": "631-265-6717",
            "fax_number": "631-265-6714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIN MEDICAL SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-08",
        "last_updated": "2014-08-22",
        "status": "A",
        "authorized_official_last_name": "MARIN",
        "authorized_official_first_name": "EDGAR",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "631-265-6717",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "131675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2014; 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.