Ken Makio Marriner, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A128587 Issued in CA

Practice address

3451 E 12TH St
Oakland, CA 94601-3463

Phone

(510) 535-3500

Fax

(510) 535-7863

NPI assigned

Aug 8, 2012

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

State University of New York Downstate Medical Center, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

La Clinica de la Raza IncGroup PAC ID 1557258282, 130 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ace Home Health Care & Hospice, Inc Home health agency, Orinda, CA, CCN 059461
• Alta Bates Summit Medical Center Hospital, Oakland, CA, CCN 050043
• Alta Bates Summit Medical Center - Alta Bates Camp Hospital, Berkeley, CA, CCN 050305

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: kmarriner319350@hisp.ehr.sutterhealth.org
• Direct secure messaging: kmarriner306392@direct.ochin.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• La Clinica de la Raza Inc

  • Federally Qualified Health Center (FQHC)
  • Concord, CA
  • NPI 1538181482
  Medicare reassignment Care Compare group
• La Clinica de la Raza Inc

  • Federally Qualified Health Center (FQHC)
  • Oakland, CA
  • NPI 1144336181
  NPD
• La Clinica de la Raza Inc

  • Federally Qualified Health Center (FQHC)
  • Oakland, CA
  • NPI 1346262292
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ace Home Health Care & Hospice Inc

  • Home Health Agency
  • Orinda, CA
  • NPI 1437442878
  Care Compare affiliation
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Oakland, CA
  • NPI 1295181477
  Care Compare affiliation
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Berkeley, CA
  • NPI 1639523004
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1344384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1013264126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3451 E 12TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946013463",
            "telephone_number": "510-535-3500",
            "fax_number": "510-535-7863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3451 E 12TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946013463",
            "telephone_number": "510-535-3500",
            "fax_number": "510-535-7863"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Potrero Ave",
            "address_2": "Bldg 80-83",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941103518",
            "country_code": "US",
            "telephone_number": "415-206-3551",
            "fax_number": "415-205-8387",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARRINER",
        "first_name": "KEN",
        "middle_name": "MAKIO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A128587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leia Marquez
• Lorena Lizette Marquez
• Rosemary Marquez
• Joseph Marquis, MD
• Paschen Marrable
• Yesenia Catalina Marsala
• Roger Marsden, PH.D MFT
• Jermaine Marsh
• Vernita A Marsh, PH.D.
• Alyssa Marshall

• Family Medicine Physician in Oakland, CA
• Providers in Oakland, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.