Organization Active NPI

Samuel N Marcus MD Inc.

  • Gastroenterology Physician
  • Mountain View, CA
National Provider Identifier
1053790691
Registry record updated Jul 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A50154 Issued in CA
Legal business name
SAMUEL N MARCUS MD INC.
Practice address
2490 Hospital Dr
Suite 211
Mountain View, CA 94040-4122
Phone
(650) 988-7488
Fax
(650) 988-7486
NPI assigned
May 28, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2024

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

Authorized official

Name
Dr. Sameul N Marcus, MD
Title
President
Phone
(650) 988-7488

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X A50154 CA Primary

Addresses

Primary practice location

2490 Hospital Dr
Suite 211
Mountain View, CA 94040-4122

Mailing address

2490 Hospital Dr
Suite 211
Mountain View, CA 94040-4122
Phone (650) 988-7488

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150608001559 CA Part B Supplier - Clinic/Group Practice 3971748047 Receives reassigned benefits from 2 practitioners
Practice locations: Mountain View, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1432771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721260800000",
    "number": "1053790691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2490 HOSPITAL DR",
            "address_2": "SUITE 211",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940404122",
            "telephone_number": "650-988-7488",
            "fax_number": "650-988-7486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2490 HOSPITAL DR",
            "address_2": "SUITE 211",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940404122",
            "telephone_number": "650-988-7488",
            "fax_number": "650-988-7486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMUEL N MARCUS MD INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-28",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A",
        "authorized_official_last_name": "MARCUS",
        "authorized_official_first_name": "SAMEUL",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "650-988-7488",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A50154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain View, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.