Individual provider Active NPI

Marinelle Camilon

  • Family Medicine Physician
  • Glendale, CA
National Provider Identifier
1023559259
Registry record updated Feb 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A16764 Issued in CA
Practice address
1509 Wilson Terrace Drive
Rehab Building, Ground Floor, RM 7G03
Glendale, CA 91206-4007
Phone
(858) 349-6454
NPI assigned
Mar 20, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 20A16764 CA Primary

Addresses

Primary practice location

1509 Wilson Terrace Drive
Rehab Building, Ground Floor, RM 7G03
Glendale, CA 91206-4007

Mailing address

1509 Wilson Terrace Drive
Rehab Building, Ground Floor, RM 7G03
Glendale, CA 91206-4007
Phone (858) 349-6454

Other practice location 1

18460 Roscoe Blvd
Northridge, CA 91325-4107
Phone (818) 993-4054

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200717001680 CA Practitioner - Family Practice 8123443835 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
San Pedro Hospitalist Medical Group IncGroup PAC ID 4183191554, 12 clinicians
Ca Hospital Hospitalist Medical Group IncGroup PAC ID 8527309442, 11 clinicians
Arcadia Hospitalist Medical Group IncGroup PAC ID 1951555366, 30 clinicians
Lakewood Hospitalist Medical Group IncGroup PAC ID 4981141496, 23 clinicians
Little Company Hospitalist Medical Group IncGroup PAC ID 0648755611, 23 clinicians

Practice addresses (Care Compare)

1300 W 7TH St
San Pedro, CA 90732-3505
Phone (310) 832-3311

1401 S Grand Ave
Los Angeles, CA 90015-3010
Phone (213) 748-2411

300 W Hungtington Dr
Arcadia, CA 91007-3402
Phone (626) 898-8000

3700 S St
Lakewood, CA 90712-1419
Phone (310) 698-5452

4101 Torrance Blvd
Torrance, CA 90503-4607
Phone (310) 540-7676

Hospital & facility affiliations

  • California Hospital Medical Center la Hospital, Los Angeles, CA, CCN 050149
  • Providence Little Co of Mary Med Ctr San Pedro Hospital, San Pedro, CA, CCN 050078
  • Providence Little Company of Mary Med Ctr Torrance Hospital, Torrance, CA, CCN 050353
  • Usc Arcadia Hospital Hospital, Arcadia, CA, CCN 050238

Merit-based Incentive Payment System (MIPS)

Final score
94.54 of 100Reported as group
Improvement activities
40
Cost
69.07

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Improvement activities
40
Cost
81.51

Merit-based Incentive Payment System (MIPS)

Final score
99.58 of 100Reported as group
Improvement activities
40
Cost
79.16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A16764CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arcadia Hospitalist Medical Group, Inc. Single Specialty CurrentSince Nov 1, 2022 Accepting new patients
Lakewood Hospitalist Medical Group, Inc Single Specialty CurrentSince Oct 1, 2024 Accepting new patients
Palomar Hospitalist Medical Group, Inc Single Specialty CurrentSince Aug 1, 2021 Accepting new patients
Merced Hospitalist Medical Group, Inc. Single Specialty CurrentSince Dec 1, 2020 Accepting new patients
Ca Hospital Hospitalist Medical Group Inc Single Specialty CurrentSince Apr 1, 2021 Accepting new patients

Locations

300 W Huntington Dr
Arcadia, CA 91007
Phone (626) 445-4441

2185 Citracado Pkwy
Escondido, CA 92029
Phone (442) 281-5000

3700 South St
Lakewood, CA 90712
Phone (562) 424-2900

1401 S Grand Ave
Los Angeles, CA 90015
Phone (213) 742-5555

333 Mercy Ave
Merced, CA 95340
Phone (209) 385-1280

15615 Pomerado Rd
Poway, CA 92064
Phone (858) 613-4000

Organizations & group practices 7

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1489968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612396800000",
    "number": "1023559259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 WILSON TERRACE DRIVE",
            "address_2": "REHAB BUILDING, GROUND FLOOR, RM 7G03",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064007",
            "telephone_number": "858-349-6454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 WILSON TERRACE DRIVE",
            "address_2": "REHAB BUILDING, GROUND FLOOR, RM 7G03",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064007",
            "telephone_number": "858-349-6454"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18460 Roscoe Blvd",
            "address_purpose": "LOCATION",
            "city": "Northridge",
            "state": "CA",
            "postal_code": "913254107",
            "country_code": "US",
            "telephone_number": "818-993-4054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMILON",
        "first_name": "MARINELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-20",
        "last_updated": "2021-02-04",
        "certification_date": "2021-01-29",
        "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": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A16764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.