NPIMap

Individual provider Active NPI

Marlyss Barton Dubois, PA

  • Medical Physician Assistant
  • Cortland, NY
National Provider Identifier
1972945541
Registry record updated Mar 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
016687 Issued in NY
Practice address
134 Homer Ave
Cortland, NY 13045-1206
Phone
(607) 756-3561
Fax
(607) 428-5142
NPI assigned
Jul 24, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 016687 NY Primary

Addresses

Primary practice location

134 Homer Ave
Cortland, NY 13045-1206

Mailing address

134 Homer Ave
Cortland, NY 13045-1206
Phone (607) 758-8019

Other names 1

  • Marlyss B Darrow Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mdubois161691@direct-guthrie.org Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130815000148 NY Practitioner - Physician Assistant 2264674688 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Guthrie Medical Group PCGroup PAC ID 6002728656, 795 clinicians

Practice addresses (Care Compare)

130 Ctr Way
Corning, NY 14830-2255
Phone (607) 936-9971

134 Homer Ave
Cortland, NY 13045-1206
Phone (607) 756-3500

1780 Hanshaw Rd
Ithaca, NY 14850-9105
Phone (607) 257-5858

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
016687NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Unity Hospital of Rochester CurrentSince Jul 9, 2013 Accepting new patients
The Unity Hospital of Rochester CurrentSince Jul 9, 2013 Accepting new patients
Guthrie Medical Group, P.C. CurrentSince Oct 1, 2020 Accepting new patients
Guthrie Medical Group, P.C. CurrentSince Oct 1, 2020 Accepting new patients
Guthrie Medical Group PC Past Accepting new patients

Locations

130 Center Way
Corning, NY 14830
Phone (607) 936-9971

134 Homer Ave
Cortland, NY 13045
Phone (607) 756-3500

1555 Long Pond Rd
Rochester, NY 14626
Phone (585) 429-2289

1 Guthrie Sq
Sayre, PA 18840
Phone (570) 887-3106

Interoperability endpoints

  • Direct secure messaging: mdubois161691@direct-guthrie.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 and National Provider Directory roles.

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": "1374624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1972945541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 HOMER AVE",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "130451206",
            "telephone_number": "607-758-8019",
            "fax_number": "607-758-8210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 HOMER AVE",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "130451206",
            "telephone_number": "607-756-3561",
            "fax_number": "607-428-5142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBOIS",
        "first_name": "MARLYSS",
        "middle_name": "BARTON",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-24",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "016687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdubois161691@direct-guthrie.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "134 Homer Ave",
            "city": "Cortland",
            "state": "NY",
            "country_code": "US",
            "postal_code": "130451206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARLYSS",
            "last_name": "DARROW",
            "middle_name": "B",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cortland, NY

Sources for this page

Verify at the official NPI Registry.