Matthew C Marcenelle

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

7090 Issued in CT

Practice address

31 Mohegan Ave
New London, CT 06320-8103

Phone

(860) 444-8402

NPI assigned

Dec 18, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1734480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1831906288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 CHARLTON LN",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063407706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 MOHEGAN AVE",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063208103",
            "telephone_number": "860-444-8402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCENELLE",
        "first_name": "MATTHEW",
        "middle_name": "C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-18",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "7090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Mann, PA-C
• Thomas Manning, MD
• Karen Allyson Manor, RN
• Aysha Mansour
• Latanya Manu, MS, MFT
• Thomas Marcille, OTR/L
• Cheryl Marsh, APRN
• Heather Anne Marshall, MA
• Olga Marsillio, DNP
• Paula Marte, MSW, LMSW

• Medical Physician Assistant in New London, CT
• Providers in New London, CT by specialty
• Medical Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2025; 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.