Individual provider Active NPI

Elizabeth Marin, APRN-CNP

  • Gerontology Nurse Practitioner
  • Edinburg, TX
National Provider Identifier
1902637440
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
1082966 Issued in TX
Practice address
5520 Leonardo Da Vinci Ste 100
Edinburg, TX 78539-1422
Phone
(956) 362-3636
Fax
(956) 362-2699
NPI assigned
Aug 7, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 1082966 TX Primary

Addresses

Primary practice location

5520 Leonardo Da Vinci Ste 100
Edinburg, TX 78539-1422

Mailing address

PO Box 6139
McAllen, TX 78502-6139
Phone (956) 362-3636

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240826003292 TX Practitioner - Nurse Practitioner 8426597113 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Renaissance GastroenterologyGroup PAC ID 7810110780, 19 clinicians

Practice addresses (Care Compare)

5520 Leonardo Da Vinci
Suite 100
Edinburg, TX 78539-1422
Phone (956) 362-3636

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Renaissance Gastroenterology Gerontology CurrentSince Aug 12, 2024 Accepting new patients

Locations

5520 Leonardo Da Vinci
Ste 100
Edinburg, TX 78539

101 N FM 3167
Ste 106
Rio Grande City, TX 78582
Phone (956) 352-1431

Organizations & group practices 1

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.

Hospital & facility affiliations 2

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": "1722988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1902637440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6139",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785026139",
            "telephone_number": "956-362-3636",
            "fax_number": "956-362-2699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5520 LEONARDO DA VINCI STE 100",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785391422",
            "telephone_number": "956-362-3636",
            "fax_number": "956-362-2699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARIN",
        "first_name": "ELIZABETH",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-07",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "1082966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edinburg, TX

Sources for this page

Verify at the official NPI Registry.