NPIMap

Individual provider Active NPI

Marena Euashachai, DO

  • Family Medicine Physician
  • Corinth, NY
National Provider Identifier
1841584489
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
271644 Issued in NY
Practice address
13 Palmer Ave
Evergreen Health Center
Corinth, NY 12822-1145
Phone
(518) 654-6499
Fax
(518) 654-7303
NPI assigned
May 31, 2011
Last updated
Feb 10, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 271644 NY Primary
Acupuncturist 171100000X A271644

Addresses

Primary practice location

13 Palmer Ave
Evergreen Health Center
Corinth, NY 12822-1145

Mailing address

100 Park Street
Glens Falls Hospital - Credentialing
Glens Falls, NY 12801
Phone (518) 926-5924

Other identifiers 1

IdentifierTypeStateIssuer
04060555MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address marena.euashachai@cdirectglensfallshosp.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160502001243 NY Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 1355573890 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Osteopathic Manipulative Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Glens Falls Hospital IncGroup PAC ID 8325955974, 175 clinicians

Practice addresses (Care Compare)

13 Palmer Ave
Corinth, NY 12822-1145
Phone (518) 654-6499

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Glens Falls Hospital Inc. Family Medicine CurrentSince Apr 1, 2016 Accepting new patients
Glens Falls Hospital Inc CurrentSince Apr 1, 2016 Accepting new patients

Locations

13 Palmer Ave
Corinth, NY 12822
Phone (518) 654-6499

100 Park St
Glens Falls, NY 12801
Phone (518) 926-5924

79 North St
Granville, NY 12832
Phone (518) 642-0612

Interoperability endpoints

  • Direct secure messaging: meuashachai95195@albanymed.direct-ci.com

Organizations & group practices 2

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.

Hospital & facility affiliations 27

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1306800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1841584489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PARK STREET",
            "address_2": "GLENS FALLS HOSPITAL - CREDENTIALING",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "12801",
            "telephone_number": "518-926-5924",
            "fax_number": "518-926-6983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 PALMER AVE",
            "address_2": "EVERGREEN HEALTH CENTER",
            "city": "CORINTH",
            "state": "NY",
            "postal_code": "128221145",
            "telephone_number": "518-654-6499",
            "fax_number": "518-654-7303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EUASHACHAI",
        "first_name": "MARENA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-31",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "271644",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": null,
            "license": "A271644",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04060555",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "marena.euashachai@cdirectglensfallshosp.org",
            "affiliation": "N",
            "address_1": "13 Palmer Ave",
            "address_2": "Evergreen Health Center",
            "city": "Corinth",
            "state": "NY",
            "country_code": "US",
            "postal_code": "128221145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Corinth, NY

Sources for this page

Verify at the official NPI Registry.