Individual provider Active NPI

Marielle Samson Daclan, MD

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Norfolk, VA
National Provider Identifier
1942837661
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
License
0101283199 Issued in VA
Practice address
600 Gresham Dr FL 7
Norfolk, VA 23507-1904
Phone
(757) 388-3447
Fax
(757) 388-5340
NPI assigned
Mar 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Emergency Medicine) Physician 207PH0002X MT229392 PA
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 2025-00616 NC
Student in an Organized Health Care Education/Training Program 390200000X
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 0101283199 VA Primary

Addresses

Primary practice location

600 Gresham Dr FL 7
Norfolk, VA 23507-1904

Mailing address

111 E 18TH St Apt 416
Norfolk, VA 23517-0020
Phone (609) 334-9158

Other practice location 1

5501 Old York Rd
Philadelphia, PA 19141-3018
Phone (215) 456-7890

Other practice location 2

100 Madison Ave
Morristown, NJ 07960-6136
Phone (973) 971-5000

Other practice location 3

1144 N Road St
Elizabeth City, NC 27909-3473
Phone (252) 384-2518

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240912003227 VA Practitioner - Hospice/Palliative Care 6204376551 Reassigns benefits to 1 organization
I20250618000863 NC Practitioner - Hospice/Palliative Care 6204376551 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospice/Palliative Care
Education
Rutgers, Robert Woood Johnson Medical School, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

600 Gresham Dr
Norfolk, VA 23507-1904
Phone (757) 388-3934

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT229392PAMDHospice and Palliative Medicine (Emergency Medicine) Physician
2025-00616NCMDHospice and Palliative Medicine (Internal Medicine) Physician
0101283199VAMDHospice and Palliative Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Albemarle Physician Services - Sentara, Inc CurrentSince Mar 13, 2025 Accepting new patients
Sentara Medical Group Hospice and Palliative Medicine CurrentSince Aug 1, 2024 Accepting new patients
Albemarle Physician Services - Sentara, Inc CurrentSince Mar 13, 2025 Accepting new patients

Locations

211 Virginia Rd
Edenton, NC 27932
Phone (252) 384-2590

905 Thunder Rd
Ste 210
Elizabeth City, NC 27909
Phone (252) 334-0460

3050 Halstead Blvd Ext
Elizabeth Cty, NC 27909
Phone (252) 334-0402

1144 N Road St
Elizabeth Cty, NC 27909
Phone (252) 384-4610

600 Gresham Dr
Fl 7
Norfolk, VA 23507
Phone (757) 388-3447

600 Gresham Dr
Norfolk, VA 23507
Phone (757) 473-0055

824 N Military Hwy
Ste 100
Norfolk, VA 23502
Phone (888) 236-2263

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

Organizations & group practices 3

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": "1585008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1942837661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 18TH ST APT 416",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235170020",
            "telephone_number": "609-334-9158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 GRESHAM DR FL 7",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071904",
            "telephone_number": "757-388-3447",
            "fax_number": "757-388-5340"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5501 Old York Rd",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191413018",
            "country_code": "US",
            "telephone_number": "215-456-7890",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Madison Ave",
            "address_purpose": "LOCATION",
            "city": "Morristown",
            "state": "NJ",
            "postal_code": "079606136",
            "country_code": "US",
            "telephone_number": "973-971-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1144 N Road St",
            "address_purpose": "LOCATION",
            "city": "Elizabeth City",
            "state": "NC",
            "postal_code": "279093473",
            "country_code": "US",
            "telephone_number": "252-384-2518",
            "fax_number": "252-384-4489",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DACLAN",
        "first_name": "MARIELLE",
        "middle_name": "SAMSON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-24",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PH0002X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Hospice and Palliative Medicine",
            "state": "PA",
            "license": "MT229392",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "NC",
            "license": "2025-00616",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "VA",
            "license": "0101283199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.