Active NPI
Marlene Agnes Fussner, NP
- Adult Health Nurse Practitioner
- Elmhurst, NY
National Provider Identifier
1932285137
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- F301987
- Practice address
- 79-01 Broadway
Managed Care, D1-01
Elmhurst, NY 11373-1329 - Phone
- (718) 334-2508
- Fax
- (718) 334-5990
- NPI assigned
- Oct 31, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | F301987 | NY | Primary |
Addresses
Primary practice location
79-01 Broadway
Managed Care, D1-01
Elmhurst, NY 11373-1329
Mailing address
79-01 Broadway
Managed Care, D1-01
Elmhurst, NY 11373-1329
Phone (718) 334-2508
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F301987 | NY | MD | Adult Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1429833600000",
"number": "1932285137",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "79-01 BROADWAY",
"address_2": "MANAGED CARE, D1-01",
"city": "ELMHURST",
"state": "NY",
"postal_code": "113731329",
"telephone_number": "718-334-2508",
"fax_number": "718-334-5990"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "79-01 BROADWAY",
"address_2": "MANAGED CARE, D1-01",
"city": "ELMHURST",
"state": "NY",
"postal_code": "113731329",
"telephone_number": "718-334-2508",
"fax_number": "718-334-5990"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUSSNER",
"first_name": "MARLENE",
"middle_name": "AGNES",
"name_prefix": "Ms.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-31",
"last_updated": "2015-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "NY",
"license": "F301987",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elmhurst, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2015; 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.