Individual provider Active NPI

Marc I Botnick, MD

  • Radiation Oncology Physician
  • Tarzana, CA
National Provider Identifier
1033192844
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
A72882 Issued in CA
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, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
00A728820MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040219000526 CA Practitioner - Radiation Oncology 0941195788 Reassigns benefits to 5 organizations

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
Cedars-Sinai Medical Care FoundationGroup PAC ID 0941106645, 1,684 clinicians

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 100Reported as group
Quality
84.79
Promoting interoperability
99
Improvement activities
40
Cost
73.15

Merit-based Incentive Payment System (MIPS)

Final score
92.8 of 100Reported as group
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

LicenseStateTypeSpecialty
A72882CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
American Skin Institute Inc. CurrentSince Feb 10, 2017 Accepting new patients
Cedars-Sinai Medical Care Foundation Specialist CurrentSince Jun 1, 2022 Accepting new patients
City of Hope Medical Foundation Radiation Oncology CurrentSince Feb 18, 2018 Accepting new patients
MD Solutions Medical Corp CurrentSince Apr 8, 2014 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 secure messaging: direct@cityofhope.direct-ci.com
  • Direct secure messaging: 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.

View all 24

Hospital & facility affiliations 3

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": "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

Verify at the official NPI Registry.