Marian Ayensu, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

U8946 Issued in TX

Practice address

2423 Williams Dr Ste 103
Georgetown, TX 78628-3200

Phone

(877) 800-5722

NPI assigned

Jun 2, 2021

Reactivated

Nov 28, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: marian.ayensu.1@29821.direct.athenahealth.com

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.

• Lone Star Circle of Care

  • Federally Qualified Health Center (FQHC)
  • Georgetown, TX
  • NPI 1891746970

  Pediatrics, TX

  Medicare reassignment NPD
• Lone Star Circle of Care

  • Federally Qualified Health Center (FQHC)
  • Austin, TX
  • NPI 1417195942
  NPD
• Lone Star Circle of Care

  • Federally Qualified Health Center (FQHC)
  • Austin, TX
  • NPI 1699289728
  NPD
• Lone Star Circle of Care

  • Federally Qualified Health Center (FQHC)
  • Georgetown, TX
  • NPI 1639129331
  NPD (past)

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

{
    "created_epoch": "1622592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1891361580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2423 WILLIAMS DR STE 107",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786283269",
            "telephone_number": "877-800-5722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2423 WILLIAMS DR STE 103",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786283200",
            "telephone_number": "877-800-5722"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "760 Broadway",
            "address_2": "Department of Pediatrics, Room 6B23",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "11206",
            "country_code": "US",
            "telephone_number": "718-963-7956",
            "fax_number": "718-963-7957",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AYENSU",
        "first_name": "MARIAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-02",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "deactivation_date": "2022-11-28",
        "reactivation_date": "2022-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "U8946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Georgetown, TX
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.