NPIMap

Individual provider Active NPI

Marlene Marie Othoniel, F.N.P.

  • Adult Health Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1891853651
Registry record updated Oct 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F331094-1 Issued in NY
Practice address
300 Skillman Ave
Lutheran Family Health Ctr, Community Medicine
Brooklyn, NY 11211-1607
Phone
(718) 302-7366
Fax
(718) 963-4016
NPI assigned
Dec 5, 2006
Last updated
Oct 29, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F331094-1 NY Primary

Addresses

Primary practice location

300 Skillman Ave
Lutheran Family Health Ctr, Community Medicine
Brooklyn, NY 11211-1607

Mailing address

300 Skillman Avenue
Lutheran Family Health Ctr, Community Medicine
Brooklyn, NY 11211
Phone (718) 302-7366

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
I20240403001400 NY Practitioner - Nurse Practitioner 6507204005 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
NYU Langone HospitalsGroup PAC ID 4981515699, 245 clinicians

Practice addresses (Care Compare)

301 E 17TH St
New York, NY 10003-3804
Phone (212) 598-2454

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F331094-1NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
NYU Langone Hospitals CurrentSince Jan 17, 2024 Accepting new patients
NYU Langone Hospitals Current Accepting new patients
NYU Langone Hospitals CurrentSince Jan 17, 2024 Accepting new patients
NYU Lutheran Medical Center Past Accepting new patients

Locations

300 Skillman Ave
Brooklyn, NY 11211
Phone (718) 302-7333

301 E 17th St
New York, NY 10003
Phone (212) 598-2454

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: mothoniel130432@nyumc.direct-ci.com

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414540800000",
    "number": "1891853651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SKILLMAN AVENUE",
            "address_2": "LUTHERAN FAMILY HEALTH CTR, COMMUNITY MEDICINE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11211",
            "telephone_number": "718-302-7366",
            "fax_number": "718-963-4016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SKILLMAN AVE",
            "address_2": "LUTHERAN FAMILY HEALTH CTR, COMMUNITY MEDICINE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112111607",
            "telephone_number": "718-302-7366",
            "fax_number": "718-963-4016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTHONIEL",
        "first_name": "MARLENE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2014-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F331094-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.