Individual provider Active NPI

Michael Marzano, OT

  • Specialist
  • Bellmore, NY
National Provider Identifier
1841382405
Registry record updated Jan 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
0100050 Issued in NY
Practice address
2721 Lee PL
Bellmore, NY 11710-5003
Phone
(516) 729-4834
NPI assigned
Sep 29, 2006
Last updated
Jan 14, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 0100050 NY Primary

Addresses

Primary practice location

2721 Lee PL
Bellmore, NY 11710-5003

Mailing address

2721 Lee PL
Bellmore, NY 11710-5003
Phone (516) 729-4834

Other identifiers 1

IdentifierTypeStateIssuer
02584632MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041229000952 NY Practitioner - Occupational Therapist in Private Practice 8628036167 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Home Advantage Occupational Therapy, P.C.Group PAC ID 4385819218, 8 clinicians

Practice addresses (Care Compare)

12 Platinum Court
Medford, NY 11763-2247
Phone (516) 729-4834

12 Platinum CT
Medford, NY 11763-2247
Phone (516) 729-4834

2721 Lee PL
Bellmore, NY 11710-5003

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
010005NYMDOptometrist
0100050NYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Home Advantage Occupational Therapy, P.C. Specialist CurrentSince Nov 15, 2011 Accepting new patients
A Merryland Operating LLC Past Accepting new patients
Reliance Healthcare Past Accepting new patients
Mermaid Operating Co, LLC PastSince Nov 4, 2005 Accepting new patients

Locations

12 Platinum Ct
Medford, NY 11763
Phone (516) 729-4834

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231891200000",
    "number": "1841382405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2721 LEE PL",
            "city": "BELLMORE",
            "state": "NY",
            "postal_code": "117105003",
            "telephone_number": "516-729-4834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2721 LEE PL",
            "city": "BELLMORE",
            "state": "NY",
            "postal_code": "117105003",
            "telephone_number": "516-729-4834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARZANO",
        "first_name": "MICHAEL",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2009-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "0100050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02584632",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellmore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.