Active NPI
Mariam Philip Korah, MD
- Radiation Oncology Physician
- Antioch, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiation Oncology Physician
- License
- 001392
- Practice address
- 4721 Dallas Ranch Rd
Antioch, CA 94531-8811 - Phone
- (925) 778-0679
- Fax
- (925) 778-3567
- NPI assigned
- Jan 28, 2008
- Last updated
- Jul 23, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiation Oncology Physician | 2085R0001X | 001392 | GA | Primary |
Addresses
Primary practice location
4721 Dallas Ranch Rd
Antioch, CA 94531-8811
Mailing address
4721 Dallas Ranch Rd
Antioch, CA 94531-8811
Phone (925) 778-0679
Other names 1
- Dr. Mariam Philip Korah
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Radiation Oncology
- Education
- University of Florida College of Medicine, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
4721 Dallas Ranch Rd
Antioch, CA 94531-8811
Phone (925) 778-0679
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001392 | GA | MD | Corneal and Contact Management Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Epic Care | Current | Accepting new patients | |
| Keck Medical Center of Usc | Past | Accepting new patients | |
| John Muir Health | Past | Accepting new patients | |
| Usc University Hospital, Inc. | Past | Accepting new patients |
Locations
4721 Dallas Ranch Rd
Antioch, CA 94531
Phone (925) 676-2600
6380 Clark Ave
Dublin, CA 94568
Phone (925) 277-1900
27204 Calaroga Ave
Hayward, CA 94545
Phone (510) 732-6930
400 Taylor Blvd
Ste 201
Pleasant Hill, CA 94523
Phone (510) 783-6865
355 Lennon Ln
Ste 205
Walnut Creek, CA 94598
Phone (925) 935-0627
Interoperability endpoints
- mkorah113371@ehr.johnmuirhealth.com
Organizations & group practices 4
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.
-
- Multi-Specialty Clinic/Center
- Antioch, CA
- NPI 1780107797
-
- Rehabilitation Hospital Unit
- Walnut Creek, CA
- NPI 1447269303
-
dba USC Kenneth Norris Jr. Hospital
- General Acute Care Hospital
- Los Angeles, CA
- NPI 1417554528
-
dba USC Hospital
- Psychiatric Hospital Unit
- Los Angeles, CA
- NPI 1790718500
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Eden Medical Center
- General Acute Care Hospital
- Castro Valley, CA
- NPI 1063812907
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406073600000",
"number": "1083891543",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4721 DALLAS RANCH RD",
"city": "ANTIOCH",
"state": "CA",
"postal_code": "945318811",
"telephone_number": "925-778-0679",
"fax_number": "925-778-3567"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4721 DALLAS RANCH RD",
"city": "ANTIOCH",
"state": "CA",
"postal_code": "945318811",
"telephone_number": "925-778-0679",
"fax_number": "925-778-3567"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KORAH",
"first_name": "MARIAM",
"middle_name": "PHILIP",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-01-28",
"last_updated": "2014-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0001X",
"taxonomy_group": "",
"desc": "Radiology, Radiation Oncology",
"state": "GA",
"license": "001392",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARIAM",
"last_name": "KORAH",
"middle_name": "PHILIP",
"prefix": "DR.",
"credential": "MD",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Antioch, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2014; 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.