Elpidio C Mariano, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

A39817 Issued in CA

Practice address

106 Lynch Creek Way
Suite 9B
Petaluma, CA 94954-2356

Phone

(707) 763-1575

Fax

(707) 763-9172

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

General Surgery

Education

Other, 1971

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Petaluma Valley Hospital Hospital, Petaluma, CA, CCN 050136

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  Medicare reassignment Care Compare group
• Providence Medical Foundation

  • General Practice Physician
  • Diamond Bar, CA
  • NPI 1285890624
  NPD
• Providence Medical Foundation

  • Surgery Physician
  • Eureka, CA
  • NPI 1477790517
  NPD

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

• Norcal Healthconnect LLC

  • General Acute Care Hospital
  • Petaluma, CA
  • NPI 1235162645
  Care Compare affiliation

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284422400000",
    "number": "1063524528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 LYNCH CREEK WAY",
            "address_2": "SUITE 9B",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949542356",
            "telephone_number": "707-763-1575",
            "fax_number": "707-763-9172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 LYNCH CREEK WAY",
            "address_2": "SUITE 9B",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949542356",
            "telephone_number": "707-763-1575",
            "fax_number": "707-763-9172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARIANO",
        "first_name": "ELPIDIO",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2010-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A39817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A398170",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Elizabeth Manulkin, FNP-BC
• Allison Marbella
• Julie Anne Marchione, RDH
• Alondra Mares
• Paul E. Margolis, LMFT
• Marin Apothecaries
• Katey Marin
• Mark R Northfield, M.D.
• Maryann Marks
• Marissa Nicole Benson Marquez, BCBA

• Surgery Physician in Petaluma, CA
• Providers in Petaluma, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2010; 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.