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Deactivated NPI 1891361580 Deactivated / Inactive NPI Female Practitioner

Dr. Marian Ayensu , MD

Pediatrics • Georgetown, TX

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Marian Ayensu has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date June 02, 2021
NPI Deactivation Date November 28, 2022
Total Practice Duration ~1 Years of Practice (2021 – 2022)

Professional Overview & Biography Verified Profile Summary

Dr. Marian Ayensu, MD was a registered Pediatrics practicing in Georgetown, TX. Throughout an active medical career spanning 1 years, Dr. Ayensu provided care at the practice location at 2423 WILLIAMS DR STE 103 until profile deactivation on 2022-11-28.

Practice Location & Contact Primary Location

Practice Address

2423 Williams Dr Ste 103

Georgetown, TX 786283200

Telephone 8778005722
Associated Practice Facility / Clinic
🏢 Lone Star Circle Of Care Facility NPI 1437109881

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Georgetown, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 9.0 Yrs
State Avg: 22.0 Yrs
Regional Practice Density
14 Specialists

Practicing in Georgetown, TX (5841 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-06-27
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License TX U8946

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Secondary Practice Locations

760 Broadway, Department Of Pediatrics, Room 6b23

Brooklyn, NY 11206

Phone: 7189637956

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
NPI 1003341082

Doctor of Medicine (M.D.)

Dr. Jared Kealy , MD

Family Medicine

NPI 1003430208

Doctor of Medicine (M.D.)

Anjana Parad

Counselor - Professional

NPI 1003578618
Dr. Sue Moss , MD

Psychiatry & Neurology - Psychiatry

NPI 1013018597

Doctor of Medicine (M.D.)

NPI 1013171412

Doctor of Medicine (M.D.)

Vanessa Frassati , APRN

Nurse Practitioner - Psychiatric/Mental Health

NPI 1013385624

Advanced Practice Registered Nurse

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

13 Historical Events
📍
Updated Business Mailing Address June 27, 2025

Registered at 2423 WILLIAMS DR STE 107, GEORGETOWN, TX 786283269 (Tel: 8778005722)

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Medical Taxonomy / Specialty Registered (Primary Specialty) June 27, 2025

Student in an Organized Health Care Education/Training Program

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Updated Practice Location September 13, 2024

Registered at 2423 WILLIAMS DR STE 103, GEORGETOWN, TX 786283200 (Tel: 8778005722)

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Updated Business Mailing Address September 13, 2024

Registered at 205 E UNIVERSITY AVE STE 200, GEORGETOWN, TX 786266821 (Tel: 5129941933)

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Medical Taxonomy / Specialty Registered (Primary Specialty) September 13, 2024

Pediatrics (License #U8946 in TX)

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NPI Profile Deactivated November 28, 2022

Record deactivated on November 28, 2022

🔄
NPI Profile Reactivated November 28, 2022

Record officially reactivated for active practice on November 28, 2022

NPI Profile Active June 02, 2021

NPI status registered as active in NPPES database

📍
Updated Practice Location June 02, 2021

Registered at 760 BROADWAY, DEPARTMENT OF PEDIATRICS, ROOM 6B23, BROOKLYN, NY 11206 (Tel: 7189637956)

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Updated Business Mailing Address June 02, 2021

Registered at 760 BROADWAY, DEPARTMENT OF PEDIATRICS, ROOM 6B23, BROOKLYN, NY 11206 (Tel: 7189637956)

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Provider Name / Credentials Updated June 02, 2021

Recorded as MARIAN AYENSU, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) June 02, 2021

Student in an Organized Health Care Education/Training Program

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Initial NPI Registration & Enumeration June 02, 2021

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1891361580
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 02, 2021
Last Update: June 27, 2025
Deactivation Date: November 28, 2022
Sole Proprietor: No

Mailing Address

2423 Williams Dr Ste 107

Georgetown, TX 786283269

Phone: 8778005722

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.