Individual provider Active NPI

Patricia C Marrello, FNP

  • Family Nurse Practitioner
  • Rome, NY
National Provider Identifier
1912909870
Registry record updated Mar 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F333620-1 Issued in NY
Practice address
1819 Black River Blvd N
Rome, NY 13440-2451
Phone
(315) 338-7184
Fax
(315) 339-1975
NPI assigned
Aug 11, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F333620-1 NY Primary

Addresses

Primary practice location

1819 Black River Blvd N
Rome, NY 13440-2451

Mailing address

1819 Black River BVLD
Rome, NY 13440-2451
Phone (315) 338-7184

Other identifiers 1

IdentifierTypeStateIssuer
02438957MedicaidNY

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F333620-1NYMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457654400000",
    "number": "1912909870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1819 BLACK RIVER BVLD",
            "city": "ROME",
            "state": "NY",
            "postal_code": "134402451",
            "telephone_number": "315-338-7184",
            "fax_number": "315-339-1975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1819 BLACK RIVER BLVD N",
            "city": "ROME",
            "state": "NY",
            "postal_code": "134402451",
            "telephone_number": "315-338-7184",
            "fax_number": "315-339-1975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARRELLO",
        "first_name": "PATRICIA",
        "middle_name": "C",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-11",
        "last_updated": "2016-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F333620-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02438957",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2016; 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.