Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. MARY ELLEN RENNA M.D.
NPI 1336111780
Pediatrics - Adolescent Medicine in Woodbury, NY

Q: What is Mary Renna's NPI number?

The NPI number for Mary Renna is 1336111780. It was assigned to this individual provider in the NPPES registry on February 1, 2006.

Q: What is Mary Renna's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Adolescent Medicine, with taxonomy code 2080A0000X.

Q: When was this NPI record last updated?

The NPPES record for Mary Renna was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 41 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 01, 2006PECOS Enrolled

40 CROSSWAYS PARK DR, WOODBURY, NY 11797(516) 677-9628(516) 677-9623 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Dr. Mary Ellen Renna M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MARY ELLEN RENNA M.D. (NPI 1336111780) is an individual adolescent medicine provider in Woodbury, New York, licensed in New York (171285) and active in the NPI registry since February 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1336111780

Entity TypeIndividualFemale

Primary Taxonomy2080A0000X

Provider Legal NameDR. MARY ELLEN RENNACredential: M.D.

Location Address40 CROSSWAYS PARK DRWoodbury, NY 11797-2036

Mailing Address40 Crossways Park DrWoodbury, NY 11797-2036 · (516) 677-9628 · Fax (516) 677-9623

Phone(516) 677-9628

Fax(516) 677-9623

Sole ProprietorNo

Enumeration DateFebruary 1, 2006

Last NPPES UpdateJuly 13, 2026

✔ NPI 1336111780 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Adolescent MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2080A0000X

License✔ Licensed in NY · 171285

Definition

A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.

40 CROSSWAYS PARK DR, Woodbury, NY 11797

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Mary Ellen Renna M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HON CHEUNG CHAN MD

Internal Medicine (Hematology & Oncology)

40 CROSSWAYS PARK DR, SUITE 103
WOODBURY, NY 11797

Nassau County (516) 921-5533

DR. FARIBA IRANI DDS

Dentist

40 CROSSWAYS PARK DR
WOODBURY, NY 11797

Nassau County (516) 921-6010

BRUCE IRA KAPPEL MD

Internal Medicine (Hematology & Oncology)

40 CROSSWAYS PARK DR, STE 103
WOODBURY, NY 11797

Nassau County (516) 921-5533

DR. STACEY SHAPIRO M.D.

Pediatrics (Adolescent Medicine)

40 CROSSWAYS PARK DR
WOODBURY, NY 11797

Nassau County (516) 677-9658

SQUARE CARE MEDICAL GROUP, LLP

Obstetrics & Gynecology

40 CROSSWAYS PARK DR
WOODBURY, NY 11797

Nassau County (516) 496-3900

JOSEPH H PIPALA MD

Internal Medicine (Hematology & Oncology)

40 CROSSWAYS PARK DR, SUITE 103
WOODBURY, NY 11797

Nassau County (516) 921-5533

DR. MARGARITA YAROVIKOVA M.D.

Internal Medicine (Hematology & Oncology)

40 CROSSWAYS PARK DR, SUITE 103
WOODBURY, NY 11797

Nassau County (516) 921-5533

VIRGINIA OTT MSN, ONC, NP-C

Nurse Practitioner (Adult Health)

40 CROSSWAYS PARK DR, SUITE 103
WOODBURY, NY 11797

Nassau County (516) 921-5533

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mary Renna's NPI number?

The NPI number for Mary Renna is 1336111780. It was assigned to this individual provider in the NPPES registry on February 1, 2006.

Where is Mary Renna located?

Mary Renna practices at 40 Crossways Park Dr, Woodbury, NY 11797. The listed phone number is (516) 677-9628.

What is Mary Renna's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Adolescent Medicine, with taxonomy code 2080A0000X.

Is Mary Renna enrolled in Medicare?

Yes. Mary Renna is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mary Renna was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 41 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.