Carla Rodrigues Marrelli

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

033168 Issued in NY

Practice address

11050 Mt Belvedere Blvd
Fort Drum, NY 13602-2603

Phone

(315) 772-2778

NPI assigned

Feb 14, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1707868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737331200000",
    "number": "1902661416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9693A FITZSIMMONS LOOP",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "136033208",
            "telephone_number": "845-633-3117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11050 MT BELVEDERE BLVD",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "136022603",
            "telephone_number": "315-772-2778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUES MARRELLI",
        "first_name": "CARLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-14",
        "last_updated": "2025-01-20",
        "certification_date": "2025-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "NY",
            "license": "434652",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "746232",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "332840",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "033168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Paul Roberts
• Zachary Robertson, ATC, LAT
• Stephen Robinson, PA-C
• Mary June Robison, LPN
• Alexander F Roding, PSY.D.
• Jill Allyn Rogers, PA-C
• Raissa Marie Rosario, LSW
• Theresa Ann Ross
• Tanja Claudia Roy, PHYSICAL THERAPIST
• Richard Henry Rubes, PHD

• Physician Assistant in Fort Drum, NY
• Providers in Fort Drum, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2025; 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.