Santa Ann Marie Mirabella, RPA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

005789-1 Issued in NY

Practice address

1504 Richmond Road
Staten Island, NY 10304

Phone

(718) 667-0890

NPI assigned

Feb 18, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Ann Marie Mirabella Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1234915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274659200000",
    "number": "1821237611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 WOOTTON ROAD",
            "city": "ESSEX FELLS",
            "state": "NJ",
            "postal_code": "07021",
            "telephone_number": "917-734-3092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 RICHMOND ROAD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10304",
            "telephone_number": "718-667-0890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRABELLA",
        "first_name": "SANTA",
        "middle_name": "ANN MARIE",
        "name_prefix": "Ms.",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-18",
        "last_updated": "2010-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "005789-1",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00063600",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANN MARIE",
            "last_name": "MIRABELLA",
            "credential": "RPA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Christine Minieri, LMHC
• Sofiya Minkova, SI, BCBA LBA
• Robert Minlionica, DC, ATC
• Fina Minniti
• Amman Liaqat Mir, LPN
• Janeen Miraglia, DO
• Julianne Miranda
• Luis Da Graca Miranda, MD
• Marjorie G Miranda
• Janna Mirazita, LMSW

• Physician Assistant in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2010; 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.