Individual provider Active NPI

Dana Marie Marseille, M.D.

  • Pediatrics Physician
  • Los Angeles, CA
National Provider Identifier
1083860449
Registry record updated Mar 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A105250 Issued in CA
Practice address
4650 Sunset Blvd, Mailstop #113
Chla, Emergency Medicine and Transport
Los Angeles, CA 90027
Phone
(323) 361-6522
NPI assigned
Aug 16, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A105250 CA Primary

Addresses

Primary practice location

4650 Sunset Blvd, Mailstop #113
Chla, Emergency Medicine and Transport
Los Angeles, CA 90027

Mailing address

4650 Sunset Blvd, Mailstop #113
Department of Emergency Medicine and Transport
Los Angeles, CA 90027

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
I20120221000609 CA Practitioner - Emergency Medicine 5193902013 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A105250CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital Los Angeles Medical Group, Inc. Pediatrics CurrentSince Jan 25, 2019 Accepting new patients
Children'S Hospital Los Angeles Past Accepting new patients
Temple University Hospital, Inc Past Accepting new patients
Chla Teaching Clinics LLC Past Accepting new patients
Childrens Hospital of Los Angeles Past Accepting new patients

Locations

3701 Wilshire Blvd
Ste 600
Los Angeles, CA 90010
Phone (323) 361-3550

4650 W Sunset Blvd
#113
Los Angeles, CA 90027
Phone (323) 361-2109

4650 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 361-2122

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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": "1218844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363564800000",
    "number": "1083860449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4650 SUNSET BLVD, MAILSTOP #113",
            "address_2": "DEPARTMENT OF EMERGENCY MEDICINE AND TRANSPORT",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 SUNSET BLVD, MAILSTOP #113",
            "address_2": "CHLA, EMERGENCY MEDICINE AND TRANSPORT",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90027",
            "telephone_number": "323-361-6522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSEILLE",
        "first_name": "DANA",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-16",
        "last_updated": "2013-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A105250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.