Individual provider Active NPI

Marie Nirva Pelerin, RN

  • Registered Nurse
  • Brooklyn, NY
National Provider Identifier
1861742496
Registry record updated Sep 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
543377-1 Issued in NY
Practice address
397 E 46TH St
Brooklyn, NY 11203-3206
Phone
(718) 287-1526
NPI assigned
Sep 11, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 543377-1 NY Primary

Addresses

Primary practice location

397 E 46TH St
Brooklyn, NY 11203-3206

Mailing address

397 E 46TH St
Brooklyn, NY 11203-3206
Phone (718) 287-1526

Other identifiers 1

IdentifierTypeStateIssuer
YLN87464340OtherNYBLUE SHIELD

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
543377-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1347321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347321600000",
    "number": "1861742496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "397 E 46TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112033206",
            "telephone_number": "718-287-1526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "397 E 46TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112033206",
            "telephone_number": "718-287-1526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELERIN",
        "first_name": "MARIE",
        "middle_name": "NIRVA",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-11",
        "last_updated": "2012-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "543377-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "YLN87464340",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2012; 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.