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MARISA FORMICA MD
NPI 1568759041
Family Medicine - Sports Medicine in Glen Cove, NY

Active since July 05, 2011PECOS EnrolledAccepts Medicare Assignment
101 SAINT ANDREWS LN, GLEN COVE, NY 11542(516) 674-7631 Get Directions Write a Review

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

About Marisa Formica Md NPPES

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

MARISA FORMICA MD (NPI 1568759041) is an individual sports medicine provider in Glen Cove, New York, licensed in New York (280850) and active in the NPI registry since July 2011. She is enrolled in Medicare PECOS and is a graduate of Other (2009).

NPPES Registry Identity

NPI1568759041
Entity TypeIndividualFemale
Primary Taxonomy207QS0010X
Provider Legal NameMARISA FORMICACredential: MD
Location Address101 SAINT ANDREWS LNGlen Cove, NY 11542-2254
Mailing Address101 Saint Andrews LnGlen Cove, NY 11542-2254
Phone(516) 674-7631
Sole ProprietorNo
Medical School CMSOtherGraduated 2009
Enumeration DateJuly 5, 2011
Last NPPES UpdateJanuary 16, 2026
NPPES CertifiedJanuary 16, 2026
✔ NPI 1568759041 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyFamily Medicine · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QS0010X
License✔ Licensed in NY · 280850
Definition
A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.
Also ListedFamily MedicineTaxonomy 207Q00000X · License 280850 (NY)
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
101 SAINT ANDREWS LN, Glen Cove, NY 11542
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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 and accepts Medicare assignment

Marisa Formica Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9133437965
PECOS Enrollment IDI20150929000405
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.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Aspiration and/or injection of fluid large joint using ultrasound guidance 20611
This procedure involves using ultrasound technology to accurately locate a large joint, usually the knee or shoulder. A needle is then inserted to either extract fluid (aspiration) or inject medication. The ultrasound helps ensure precision and safety.
47 services13 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
23 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11542 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$117.62 typical visit price
range $21.66 – $164.45
Typical copayment $29.40 (range $5.41 – $41.11)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

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

BRUCE W MARTIN FNP
Nurse Practitioner (Family)
101 SAINT ANDREWS LN
GLEN COVE, NY 11542
Nassau County (516) 674-7461
SUBOOR AZIMI
Pharmacist
101 SAINT ANDREWS LN
GLEN COVE, NY 11542
Nassau County (516) 674-7300
DR. JOHN D'ANGELO MD
Emergency Medicine
101 SAINT ANDREWS LN
GLEN COVE, NY 11542
Nassau County (516) 674-7325
MAAYAN ESTELLE LIEBERMAN M.D.
Student in an Organized Health Care Education/Training Program
101 SAINT ANDREWS LN, NSLIJ-GLEN COVE HOSPITAL
GLEN COVE, NY 11542
Nassau County (516) 674-7631
ALI AY
Hospitalist
101 SAINT ANDREWS LN
GLEN COVE, NY 11542
Nassau County (718) 270-2353
DR. OLUMIDE ADEYEKUN MD
Student in an Organized Health Care Education/Training Program
101 SAINT ANDREWS LN
GLEN COVE, NY 11542
Nassau County (516) 674-7300
WAI C MAN D.O.
Internal Medicine
101 SAINT ANDREWS LN
GLEN COVE, NY 11542
Nassau County (516) 674-7300
GURBHUSHAN SINGH BASRA M.D.
Radiology (Diagnostic Radiology)
101 SAINT ANDREWS LN
GLEN COVE, NY 11542
Nassau County (516) 674-7540

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 Marisa Formica's NPI number?

The NPI number for Marisa Formica is 1568759041. It was assigned to this individual provider in the NPPES registry on July 5, 2011.

Where is Marisa Formica located?

Marisa Formica practices at 101 Saint Andrews Ln, Glen Cove, NY 11542. The listed phone number is (516) 674-7631.

What is Marisa Formica's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Is Marisa Formica enrolled in Medicare?

Yes. Marisa Formica is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Marisa Formica was last updated on January 16, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months 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.