Individual provider Active NPI

Crystal Gloria Marcelin, APRN

  • Nurse Practitioner
  • New York, NY
National Provider Identifier
1942878806
Registry record updated Jan 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
356756 Issued in NY
Practice address
489 5TH Ave FL 3
New York, NY 10017-6145
Phone
(888) 663-6331
Fax
(415) 252-7176
NPI assigned
Jun 16, 2021
Last updated
Jan 6, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11013490 FL
Nurse Practitioner 363L00000X 356756 NY Primary

Addresses

Primary practice location

489 5TH Ave FL 3
New York, NY 10017-6145

Mailing address

1 Embarcadero Ctr Ste 1900
San Francisco, CA 94111-3723
Phone (888) 663-6331

Other practice location 1

1400 NW 12th Ave
Miami, FL 33136-1003
Phone (305) 689-2121

Other identifiers 1

IdentifierTypeStateIssuer
11013490OtherFLAPRN LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL EPIC Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210927000501 FL Practitioner - Nurse Practitioner 1052718525 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
356756NYMDNurse Practitioner
11013490FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Miami CurrentSince Sep 1, 2021 Accepting new patients
University of Miami Current Accepting new patients
University of Miami Nurse Practitioner CurrentSince Sep 1, 2021 Accepting new patients
QMC LLC Past Accepting new patients

Locations

4800 NE 20th Ter
Ste 201
Ft Lauderdale, FL 33308
Phone (305) 892-4000

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

1400 NW 12th Ave
Miami, FL 33136
Phone (305) 325-5416

160 NW 170th St
North Miami Beach, FL 33169
Phone (305) 585-8957

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: cmarcelin78078@direct.med.miami.edu

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767657600000",
    "number": "1942878806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR STE 1900",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113723",
            "telephone_number": "888-663-6331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "489 5TH AVE FL 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100176145",
            "telephone_number": "888-663-6331",
            "fax_number": "415-252-7176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 NW 12th Ave",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331361003",
            "country_code": "US",
            "telephone_number": "305-689-2121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARCELIN",
        "first_name": "CRYSTAL",
        "middle_name": "GLORIA",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-16",
        "last_updated": "2026-01-06",
        "certification_date": "2026-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11013490",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "356756",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN LICENSE",
            "identifier": "11013490",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "EPIC",
            "affiliation": "N",
            "endpointDescription": "ELECTRONIC MEDICAL RECORD",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1400 NW 12th Ave",
            "city": "Miami",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331361003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.