Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Marie Medina-Merveille, FNPRN

Individual provider Family Nurse Practitioner · NPI 1407383193

Marie Medina-Merveille, FNPRN is a Nurse Practitioner in Bronx, New York. Qualified in 2017, 9 years ago. Practices with Shakespeare Operating LLC, a 137-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
9
Licensed in
NY
In the registry since
2017
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Practice location Address checks out

2015 Grand Concourse
Bronx, NY 10453-4303
Phone: (718) 618-0401
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence F341677-01 (NY)

Record details

NPI number1407383193
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNPRN
Sole proprietorYes
NPI enumeratedMay 12, 2017
Last updated in NPPESJune 1, 2020
Certification dateJune 1, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Shakespeare Operating Llc — 137 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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