NPIMap

Individual provider Active NPI

Marsha Funderburk Granese, M.D.

  • Obstetrics & Gynecology Physician
  • Rancho Santa Margarita, CA
National Provider Identifier
1063572915
Registry record updated Nov 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A83534 Issued in CA
Practice address
22032 El Paseo
Suite 200
Rancho Santa Margarita, CA 92688-3947
Phone
(949) 589-6487
Fax
(949) 589-6485
NPI assigned
Dec 11, 2006
Last updated
Nov 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A83534 CA Primary

Addresses

Primary practice location

22032 El Paseo
Suite 200
Rancho Santa Margarita, CA 92688-3947

Mailing address

22032 El Paseo
Suite 200
Rancho Santa Margarita, CA 92688-3947
Phone (949) 589-6487

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mgranese1373956@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110617000311 CA Practitioner - Obstetrics/Gynecology 5092608240 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kern County Hospital AuthorityGroup PAC ID 4688964521, 264 clinicians
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

1700 Mount Vernon Ave
Bakersfield, CA 93306-4018
Phone (661) 326-2000

1950 Sunny Crest Dr
Suite 2900
Fullerton, CA 92835-3641
Phone (714) 992-5350

26800 Crown Valley Pkwy
Mission Viejo, CA 92691-6384

27700 Medical Ctr Rd
Mission Viejo, CA 92691-6426
Phone (949) 364-1400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation Current Accepting new patients
Kern County Hospital Authority CurrentSince Jul 1, 2016 Accepting new patients
Kern County Hospital Authority CurrentSince Jul 1, 2016 Accepting new patients
Providence Medical Foundation CurrentSince Nov 6, 2017 Accepting new patients
Providence Medical Foundation CurrentSince Nov 6, 2017 Accepting new patients
Marsha Granese, MD, Inc. Obstetrics & Gynecology PastSince Apr 7, 2011 Accepting new patients
Mission Hospital Regional Medical Center Past Accepting new patients
Laguna Niguel Surgery Center LLC PastSince Apr 9, 2008 Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients
Womencare, Inc Past Accepting new patients
Providence Medical Foundation Obstetrics & Gynecology Past Accepting new patients

Locations

200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841

1111 Columbus St
Bakersfield, CA 93305
Phone (661) 326-5052

1700 Mount Vernon Ave
Bakersfield, CA 93306
Phone (616) 326-2000

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

26522 La Alameda
Ste 120
Mission Viejo, CA 92691
Phone (949) 282-1671

26800 Crown Valley Pkwy
Ste 300
Mission Viejo, CA 92691

26800 Crown Valley Pkwy
Ste 525
Mission Viejo, CA 92691
Phone (949) 364-1040

665 Camino de los Mares
Ste 303A
San Clemente, CA 92673
Phone (949) 364-1040

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

Interoperability endpoints

  • Direct secure messaging: mgranese1373956@oc.providencedirect.org

Organizations & group practices 11

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.

Hospital & facility affiliations 9

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": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1063572915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22032 EL PASEO",
            "address_2": "SUITE 200",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926883947",
            "telephone_number": "949-589-6487",
            "fax_number": "949-589-6485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22032 EL PASEO",
            "address_2": "SUITE 200",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926883947",
            "telephone_number": "949-589-6487",
            "fax_number": "949-589-6485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANESE",
        "first_name": "MARSHA",
        "middle_name": "FUNDERBURK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A83534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mgranese1373956@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "26800 Crown Valley Pkwy Ste 525",
            "city": "Mission Viejo",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926918029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rancho Santa Margarita, CA

Sources for this page

Verify at the official NPI Registry.