Individual provider Active NPI

Richard Thomas Marino III, PA-C

  • Physician Assistant
  • Garden City, NY
National Provider Identifier
1811800428
Registry record updated Sep 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
036584-01 Issued in NY
Practice address
877 Stewart Ave Ste 1
Garden City, NY 11530-4803
Phone
(516) 325-7310
NPI assigned
Sep 24, 2026
Last updated
Sep 24, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 036584-01 NY Primary

Addresses

Primary practice location

877 Stewart Ave Ste 1
Garden City, NY 11530-4803

Mailing address

1 Erin LN
East Setauket, NY 11733-3461
Phone (631) 513-7196

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790208000000",
    "number": "1811800428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ERIN LN",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117333461",
            "telephone_number": "631-513-7196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "877 STEWART AVE STE 1",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115304803",
            "telephone_number": "516-325-7310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINO",
        "first_name": "RICHARD",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-09-24",
        "last_updated": "2026-09-24",
        "certification_date": "2026-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "036584-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.