Active NPI
Marc I Botnick, MD
- Radiation Oncology Physician
- Tarzana, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiation Oncology Physician
- License
- A72882
- Practice address
- 18133 Ventura Blvd Ste 102
Tarzana, CA 91356-3641 - Phone
- (424) 314-7695
- Fax
- (424) 314-7699
- NPI assigned
- Nov 25, 2005
- Last updated
- Jun 1, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | A72882 | CA | |
| Radiation Oncology Physician | 2085R0001X | A72882 | CA | Primary |
Addresses
Primary practice location
18133 Ventura Blvd Ste 102
Tarzana, CA 91356-3641
Mailing address
4140 W 190TH St
Torrance, CA 90504-5513
Other practice location 1
501 S Buena Vista St
Burbank, CA 91505-4809
Phone (818) 847-3440
Other practice location 2
5522 Sepulveda Blvd
Sherman Oaks, CA 91411-3437
Phone (818) 997-1522
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A728820 | Medicaid | CA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | direct@cityofhope.direct-ci.com | CITY OF HOPE MEDICAL FOUNDATION |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Radiation Oncology
- Education
- Hahnemann University College of Medicine, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
18133 Ventura Blvd
Suite 300
Tarzana, CA 91356-3645
Phone (818) 994-0101
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 89.14 of 100
- Quality
- 84.79
- Promoting interoperability
- 99
- Improvement activities
- 40
- Cost
- 73.15
Merit-based Incentive Payment System (MIPS)
- Final score
- 92.8 of 100
- Quality
- 78.51
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 70.37
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A72882 | CA | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| American Skin Institute Inc. | Current | Accepting new patients | |
| Cedars-Sinai Medical Care Foundation | Specialist | Current | Accepting new patients |
| City of Hope Medical Foundation | Radiation Oncology | Current | Accepting new patients |
| MD Solutions Medical Corp | Current | Accepting new patients | |
| West Hills Hospital | Past | Accepting new patients | |
| Dignity Health | Past | Accepting new patients | |
| Providence Saint John's Health Center | Past | Accepting new patients | |
| Providence Health System - Southern California | Past | Accepting new patients | |
| St Jude Hospital Inc | Past | Accepting new patients | |
| Valley Radiotherapy Associates Medical Group Inc | Radiation Oncology | Past | Accepting new patients |
| Valley Oncology, P.C. | Radiation Oncology | Past | Accepting new patients |
| Providence Health System - Southern California | Past | Accepting new patients | |
| Empire Oncology PC | Radiation Oncology | Past | Accepting new patients |
| Providence Health System - Southern California | Past | Accepting new patients | |
| Santa Clarita Radiotherapy Medical Group | Radiation Oncology | Past | Accepting new patients |
| Valley Presbyterian Hospital | Past | Accepting new patients | |
| Little Company of Mary Affiliated Services Inc | Past | Accepting new patients | |
| Dignity Health | Past | Accepting new patients | |
| Henry Mayo Newhall Memorial Hospital | Past | Accepting new patients | |
| Providence St Joseph Medical Center | Past | Accepting new patients | |
| Tarzana Medical Center LLC | Past | Accepting new patients | |
| Community Hospital of San Bernardino | Past | Accepting new patients | |
| The Regents of the University of California | Past | Accepting new patients |
Locations
181 S Buena Vista St
Burbank, CA 91505
Phone (818) 840-0921
501 S Buena Vista St
Burbank, CA 91505
Phone (818) 783-0800
1500 Duarte Rd
Duarte, CA 91010
Phone (626) 359-8111
2151 N Harbor Blvd
Ste 1500
Fullerton, CA 92835
Phone (714) 446-5632
8635 W 3rd St
Ste 465W
Los Angeles, CA 90048
Phone (310) 423-0674
500 N Garfield Ave
Ste 206
Monterey Park, CA 91754
Phone (626) 288-4218
1000 W La Veta Ave
Orange, CA 92868
Phone (714) 446-5632
6939 Palm Ct
Riverside, CA 92506
Phone (760) 416-4832
1328 22nd St
Santa Monica, CA 90404
Phone (310) 829-5511
2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024
15477 Ventura Blvd
Ste 100
Sherman Oaks, CA 91403
Phone (818) 906-2141
4836 Van Nuys Blvd
Sherman Oaks, CA 91403
Phone (818) 907-7546
5522 Sepulveda Blvd
Sherman Oaks, CA 91411
Phone (818) 990-5020
209 Fair Oaks Ave
South Pasadena, CA 91030
Phone (626) 359-8111
18133 Ventura Blvd
Ste 300
Tarzana, CA 91356
Phone (310) 423-8888
4140 W 190th St
Torrance, CA 90504
Phone (310) 967-1780
28049 Smyth Dr
Valencia, CA 91355
Phone (661) 705-9706
1240 S Westlake Blvd
Ste 217
Westlake Vlg, CA 91361
Phone (805) 497-0097
36450 Inland Valley Dr
Ste 101
Wildomar, CA 92595
Phone (909) 696-0679
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- direct@cityofhope.direct-ci.com
- mbotnick415454@direct.cshs.org
Organizations & group practices 24
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Specialist
- Los Angeles, CA
- NPI 1316984388
-
- Dermatology Physician
- Sherman Oaks, CA
- NPI 1023377082
-
dba City of Hope Duarte
- Hematology & Oncology Physician
- Duarte, CA
- NPI 1871886366
Radiation Oncology
-
dba Unified Health care Inc.
- Dermatology Physician
- Sherman Oaks, CA
- NPI 1902837735
-
- Ambulatory Surgical Clinic/Center
- Sherman Oaks, CA
- NPI 1134327182
-
dba Community Convalescent Center of San Bernardino
- Pediatric Skilled Nursing Facility
- San Bernardino, CA
- NPI 1851395685
-
dba St. Bernardine Medical Center
- General Acute Care Hospital
- San Bernardino, CA
- NPI 1689769911
-
- Radiation Oncology Physician
- Temecula, CA
- NPI 1467764092
-
dba Henry Mayo Newhall Hospital
- General Acute Care Hospital
- Valencia, CA
- NPI 1780668434
-
- Psychiatric Hospital Unit
- San Pedro, CA
- NPI 1154349371
-
dba Providence Saint Joseph Medical Center
- General Acute Care Hospital
- Burbank, CA
- NPI 1336173269
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Los Angeles, CA
- NPI 1639172372
-
- General Acute Care Hospital
- West Hollywood, CA
- NPI 1891940326
-
dba Huntington Hospital
- General Acute Care Hospital
- Pasadena, CA
- NPI 1407828429
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654041600000",
"number": "1033192844",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4140 W 190TH ST",
"city": "TORRANCE",
"state": "CA",
"postal_code": "905045513"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18133 VENTURA BLVD STE 102",
"city": "TARZANA",
"state": "CA",
"postal_code": "913563641",
"telephone_number": "424-314-7695",
"fax_number": "424-314-7699"
}
],
"practiceLocations": [
{
"address_1": "501 S Buena Vista St",
"address_purpose": "LOCATION",
"city": "Burbank",
"state": "CA",
"postal_code": "915054809",
"country_code": "US",
"telephone_number": "818-847-3440",
"fax_number": "818-847-3499",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5522 Sepulveda Blvd",
"address_purpose": "LOCATION",
"city": "Sherman Oaks",
"state": "CA",
"postal_code": "914113437",
"country_code": "US",
"telephone_number": "818-997-1522",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BOTNICK",
"first_name": "MARC",
"middle_name": "I",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-25",
"last_updated": "2022-06-01",
"certification_date": "2022-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CA",
"license": "A72882",
"primary": false
},
{
"code": "2085R0001X",
"taxonomy_group": "",
"desc": "Radiology, Radiation Oncology",
"state": "CA",
"license": "A72882",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A728820",
"state": "CA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "direct@cityofhope.direct-ci.com",
"affiliation": "Y",
"affiliationName": "CITY OF HOPE MEDICAL FOUNDATION",
"address_1": "1500 Duarte Rd",
"city": "Duarte",
"state": "CA",
"country_code": "US",
"postal_code": "910103012",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Tarzana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 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.