OrganizationActive
Marcellus Family Medicine PLLC
NPI 1558791996 · Non-Pharmacy Dispensing Site · Marcellus, NY
Marcellus Family Medicine PLLC is a Non-Pharmacy Dispensing Site organization in Marcellus, NY (NPI 1558791996).
Provider details
- NPI number
- 1558791996
- Entity type
- Organization
- Primary specialty
- Non-Pharmacy Dispensing SiteSuppliers
- Parent organization
- Medvantx, Inc.
- Organization subpart
- Yes
- Authorized official
- Kenny Heine, Vp of Operations(858) 964-1506
- License
- 127430 (NY)
Specialties & taxonomies
Suppliers
Profile Score
Detailed profile(77/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
28 E Main St
Marcellus, NY 13108-1226
Phone: (315) 673-9926
Street-level locationGet directions
Mailing address
5626 Oberlin Dr
San Diego, CA 92121-1705
Other names (DBA / former)
- Doing business as
- Marcellus Family Medicine
Registry dates
- Enumerated
- 2013-11-21
- Last updated
- 2013-11-21
Frequently asked questions
- What is Marcellus Family Medicine PLLC's NPI number?
- Marcellus Family Medicine PLLC's National Provider Identifier (NPI) is 1558791996, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Marcellus Family Medicine PLLC?
- Marcellus Family Medicine PLLC is classified in the NPPES registry as Non-Pharmacy Dispensing Site (Suppliers).
- Where is Marcellus Family Medicine PLLC located?
- Marcellus Family Medicine PLLC's practice location on file with NPPES is 28 E Main St, Marcellus, NY 13108-1226.
- What is Marcellus Family Medicine PLLC's phone number?
- The practice phone number listed in the NPPES registry for Marcellus Family Medicine PLLC is (315) 673-9926.
- Who is the authorized official for Marcellus Family Medicine PLLC?
- The authorized official listed on Marcellus Family Medicine PLLC's NPPES record is Kenny Heine, Vp of Operations. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Marcellus Family Medicine PLLC's NPI active?
- Yes — Marcellus Family Medicine PLLC's NPI (1558791996) is active in the NPPES registry as of the last update on 2013-11-21.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.