Individual provider Active NPI

Katy Alyse Marino, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Little Rock, AR
National Provider Identifier
1942562186
Registry record updated Feb 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
E-12381 Issued in AR
Practice address
4301 W Markham St # 520
Little Rock, AR 72205-7101
Phone
(501) 686-8211
Fax
(501) 686-7861
NPI assigned
Jun 13, 2012
Last updated
Feb 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 50417 KY
Surgery Physician 208600000X E-12381 AR
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X E-12381 AR Primary

Addresses

Primary practice location

4301 W Markham St # 520
Little Rock, AR 72205-7101

Mailing address

4301 W Markham St # 783
Little Rock, AR 72205-7199
Phone (501) 686-8000

Other practice location 1

9500 Kanis Rd Ste 500
Little Rock, AR 72205-6389
Phone (501) 202-4715

Other names 1

  • Katy Marino Woodward Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190907000124 AR Practitioner - Thoracic SurgeryPractitioner - General SurgeryPractitioner - Cardiac Surgery 2365711249 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Thoracic SurgeryAlso: Cardiac Surgery, General Surgery
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baptist HealthGroup PAC ID 0648177949, 106 clinicians

Practice addresses (Care Compare)

4301 W Markam St
Little Rock, AR 72205-7101

9500 Kanis Rd
Little Rock, AR 72205-6324
Phone (501) 202-4715

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux41

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences CurrentSince Aug 1, 2019 Accepting new patients
University of Arkansas for Medical Sciences Surgery Current Accepting new patients
Baptist Health CurrentSince Apr 1, 2024 Accepting new patients
Baptist Health Current Accepting new patients
Baptist Health CurrentSince Apr 1, 2024 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Aug 1, 2019 Accepting new patients

Locations

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

4301 W Markham St
#520
Little Rock, AR 72205
Phone (501) 686-5205

4301 W Markham St
Little Rock, AR 72205
Phone (501) 603-1278

4301 W Markham St
#783
Little Rock, AR 72205
Phone (501) 603-1278

9500 Kanis Rd
Ste 500
Little Rock, AR 72205
Phone (501) 202-4715

104 W Taylor St
Sparkman, AR 71763
Phone (870) 678-2226

Interoperability endpoints

  • Direct secure messaging: kmarino361956@direct.baptist-healthar.org

Organizations & group practices 6

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 3

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": "1339545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1942562186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST # 783",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057199",
            "telephone_number": "501-686-8000",
            "fax_number": "501-526-5148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST # 520",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "501-686-8211",
            "fax_number": "501-686-7861"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9500 Kanis Rd Ste 500",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722056389",
            "country_code": "US",
            "telephone_number": "501-202-4715",
            "fax_number": "501-202-4755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARINO",
        "first_name": "KATY",
        "middle_name": "ALYSE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-13",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KY",
            "license": "50417",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AR",
            "license": "E-12381",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "AR",
            "license": "E-12381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATY",
            "last_name": "WOODWARD",
            "middle_name": "MARINO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.