Individual provider Active NPI

Marlon Philip Coelho, MD

  • Student in an Organized Health Care Education/Training Program
  • Syracuse, NY
National Provider Identifier
1962923706
Registry record updated Jul 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
750 E Adams St
Syracuse, NY 13210-2306
Phone
(315) 464-5540
NPI assigned
Jul 1, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

750 E Adams St
Syracuse, NY 13210-2306

Mailing address

750 E Adams St
Syracuse, NY 13210-2306

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20240318003073 GA Practitioner - Diagnostic Radiology 3072859875 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greensboro Radiology PAGroup PAC ID 8729074901, 236 clinicians
Coastal Radiology Associates PLLCGroup PAC ID 8224002696, 25 clinicians
Northside Radiology Associates LLCGroup PAC ID 4486555398, 381 clinicians

Practice addresses (Care Compare)

102 Grand Cres
Alpharetta, GA 30009-6817
Phone (336) 274-6682

1514 Vernon Rd
Lagrange, GA 30240-4131
Phone (855) 504-4544

1540 Vernon Rd
Lagrange, GA 30240-4131
Phone (336) 274-6682

15430 Little Stone Way
Milton, GA 30004-6900
Phone (770) 558-1646

167 Park Pines Cir
Grantville, GA 30220-2792
Phone (855) 504-4544

407 Lakeview Way
Lagrange, GA 30241-8792
Phone (404) 851-6577

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.75 of 100Reported as group
Quality
96.18
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Radiology Associates, PLLC CurrentSince Feb 14, 2024 Accepting new patients
Greensboro Radiology, PA CurrentSince Feb 11, 2024 Accepting new patients

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 5

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": "1498867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498867200000",
    "number": "1962923706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 E ADAMS ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E ADAMS ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102306",
            "telephone_number": "315-464-5540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COELHO",
        "first_name": "MARLON",
        "middle_name": "PHILIP",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-01",
        "last_updated": "2017-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.