Individual provider Active NPI

Gary B. Marcus, M.D.

  • Cardiovascular Disease Physician
  • San Pablo, CA
National Provider Identifier
1073526646
Registry record updated Jul 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
C28611 Issued in CA
Practice address
2101 Vale Rd
Suite 201
San Pablo, CA 94806-3835
Phone
(510) 233-9300
Fax
(510) 233-9299
NPI assigned
Aug 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X C28611 CA Primary

Addresses

Primary practice location

2101 Vale Rd
Suite 201
San Pablo, CA 94806-3835

Mailing address

2101 Vale Rd
Suite 201
San Pablo, CA 94806-3835
Phone (510) 233-9300

Other identifiers 1

IdentifierTypeStateIssuer
00C286110MedicaidCA

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
I20041208000543 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 0042276313 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
University of Cincinnati College of Medicine, 1962
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1430 Tara Hills Dr
Suite a
Pinole, CA 94564-2512
Phone (510) 640-0019

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C28611CAMDCardiovascular Disease Physician

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184112000000",
    "number": "1073526646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 VALE RD",
            "address_2": "SUITE 201",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "948063835",
            "telephone_number": "510-233-9300",
            "fax_number": "510-233-9299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 VALE RD",
            "address_2": "SUITE 201",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "948063835",
            "telephone_number": "510-233-9300",
            "fax_number": "510-233-9299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCUS",
        "first_name": "GARY",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2007-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "C28611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C286110",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Pablo, CA

Sources for this page

Verify at the official NPI Registry.