Individual provider Active NPI

Angelica Marmanillo, RN, BSN

  • Registered Nurse
  • Tarrytown, NY
National Provider Identifier
1871945998
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
533259 Issued in NY
Practice address
580 White Plains Rd Ste 510
Tarrytown, NY 10591-5152
Phone
(914) 345-5900
NPI assigned
Jul 13, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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 533259 NY Primary

Addresses

Primary practice location

580 White Plains Rd Ste 510
Tarrytown, NY 10591-5152

Mailing address

580 White Plains Rd Ste 510
Tarrytown, NY 10591-5152
Phone (914) 345-5900

Other practice location 1

1960 Goshen Tpke
Middletown, NY 10941-1361
Phone (845) 807-6794

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
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
533259NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
The Mental Health Association of Westchester County, Inc. CurrentSince Jul 17, 2022 Accepting new patients
The Mental Health Association of Westchester County - Social Care Network PastSince Jul 17, 2022 Accepting new patients

Locations

580 White Plains Rd
Ste 510
Tarrytown, NY 10591
Phone (518) 312-6335

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1468368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1871945998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 WHITE PLAINS RD STE 510",
            "city": "TARRYTOWN",
            "state": "NY",
            "postal_code": "105915152",
            "telephone_number": "914-345-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 WHITE PLAINS RD STE 510",
            "city": "TARRYTOWN",
            "state": "NY",
            "postal_code": "105915152",
            "telephone_number": "914-345-5900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1960 Goshen Tpke",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "NY",
            "postal_code": "109411361",
            "country_code": "US",
            "telephone_number": "845-807-6794",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARMANILLO",
        "first_name": "ANGELICA",
        "credential": "RN, BSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-13",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "533259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarrytown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2023; 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.