Marisa Formica, MD in Glen Cove, NY - Medicare Family Practice

Marisa Formica, MD is a medicare enrolled "Family Medicine - Sports Medicine" physician in Glen Cove, New York. She graduated from medical school in 2009 and has 17 years of diverse experience with area of expertise as Family Practice. She is a member of the group practice Mm Medical Service Pc and her current practice location is 101 Saint Andrews Ln, Glen Cove, New York. You can reach out to her office (for appointments etc.) via phone at (516) 674-7631.

Marisa Formica is licensed to practice in New York (license number 280850) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1568759041.

Contact Information

	Marisa Formica, MD
	101 Saint Andrews Ln, Glen Cove, NY 11542-2254
	(516) 674-7631
	Not Available

Map and Direction

Physician's Profile

Full Name	Marisa Formica
Gender	Female
Speciality	Family Practice
Experience	17 Years
Location	101 Saint Andrews Ln, Glen Cove, New York
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Marisa Formica graduated from medical school in 2009

NPI Data:

NPI Number: 1568759041
Provider Enumeration Date: 07/05/2011
Last Update Date: 01/16/2026

Medicare PECOS Information:

PECOS PAC ID: 9133437965
Enrollment ID: I20150929000405

Medical Identifiers

Medical identifiers for Marisa Formica such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1568759041	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	280850 (New York)	Secondary
207QS0010X	Family Medicine - Sports Medicine	280850 (New York)	Primary
390200000X	Student In An Organized Health Care Education/training Program	(* (Not Available))	Secondary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Mm Medical Service Pc	2466758297	2

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Marisa Formica allows following entities to bill medicare on her behalf.

Entity Name	City Medical Of Upper East Side Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1801277629 PECOS PAC ID: 0648465039 Enrollment ID: O20101111000052

Entity Name	Mm Medical Service Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1104281286 PECOS PAC ID: 2466758297 Enrollment ID: O20160304000336

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Marisa Formica is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Marisa Formica, MD 101 Saint Andrews Ln, Glen Cove, NY 11542-2254 Ph: () -	Marisa Formica, MD 101 Saint Andrews Ln, Glen Cove, NY 11542-2254 Ph: (516) 674-7631

Reviews and Comments

Family Medicine Doctors in Glen Cove, NY

Dr. George Francis Dunn, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: Glen Cove Hospital Family Medicine, 101 St. Andrews Lane, Glen Cove, NY 11542 Phone: 516-674-7900 Fax: 516-674-7904
Dr. Sylvia H Chudy, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1 School St, Suite 203, Glen Cove, NY 11542 Phone: 516-671-9800
Dr. Purvi M Patel, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 101 Saint Andrews Ln, Glen Cove Hospital, Glen Cove, NY 11542 Phone: 516-674-7631
Khadija Khan, Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 101 Saint Andrews Ln, Glen Cove, NY 11542 Phone: 516-674-7631 Fax: 516-674-7639
Dr. Benita Benjamin, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 10 Medical Plz, Glen Cove, NY 11542 Phone: 516-679-0239
Dr. Gregorio Reyes, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 10 Medical Plz, Ste 205, Glen Cove, NY 11542 Phone: 516-671-6900 Fax: 516-671-6901
Barbara Keber, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: Glen Cove Hospital-family Medicine, 101 St. Andrews Lane, Glen Cove, NY 11542 Phone: 516-674-7900

Marisa Formica, MD - Medicare Family Practice in Glen Cove, NY