NPIMap

Organization Active NPI

Marshall Medical Center

  • Family Medicine Physician
  • El Dorado Hills, CA
National Provider Identifier
1114727377
Registry record updated Mar 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MARSHALL MEDICAL CENTER
Practice address
4201 Town Center Blvd BLDG D
El Dorado Hills, CA 95762-7100
Phone
(916) 933-8010
Fax
(530) 748-0322
NPI assigned
Mar 17, 2025
Last updated
Mar 18, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2026

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

Authorized official

Name
Siri Nelson
Title
Ceo
Phone
(530) 622-1144

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU
Family Medicine Physician 207Q00000X NU Primary
Internal Medicine Physician 207R00000X NU
Cardiovascular Disease Physician 207RC0000X NU
Obstetrics & Gynecology Physician 207V00000X NU
Ophthalmology Physician 207W00000X NU
Orthopaedic Surgery Physician 207X00000X NU
Foot & Ankle Surgery Podiatrist 213ES0103X NU

Addresses

Primary practice location

4201 Town Center Blvd BLDG D
El Dorado Hills, CA 95762-7100

Mailing address

PO Box 45680
San Francisco, CA 94145-0680
Phone (530) 626-2618

Other practice location 1

1111 Sierra At Tahoe Rd
Twin Bridges, CA 95735-9505
Phone (530) 622-1441

Other practice location 2

4300 Golden Center Dr Ste A
Placerville, CA 95667-6278
Phone (530) 344-2020

Other names 2

  • Marshall Multispeciality TCW Other name
  • Marshall Vision Center Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031208001095 CA Part B Supplier - Clinic/Group Practice 7517875859 Receives reassigned benefits from 169 practitioners
14 other NPIs on this enrollment
Practice locations: Placerville, CA; Twin Bridges, CA; Gold River, CA; El Dorado Hills, CA; Cameron Park, CA

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 14

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 14

National Provider Directory

National Provider Directory

Locations (25 of 26)

3102 Ponte Morino Dr
Ste 100
Cameron Park, CA 95682
Phone (530) 626-9488

3501 Palmer Dr
Ste 100
Cameron Park, CA 95682
Phone (530) 626-1441

3581 Palmer Dr
#300
Cameron Park, CA 95682
Phone (530) 626-2861

3581 Palmer Dr
Ste 201
Cameron Park, CA 95682
Phone (530) 672-6220

3581 Palmer Dr
Ste 602
Cameron Park, CA 95682
Phone (530) 626-2920

3581 Palmer Dr
Ste 608
Cameron Park, CA 95682
Phone (530) 672-7000

4201 Town Center Blvd
#D
El Dorado Hills, CA 95762

6065 State Highway 193
Georgetown, CA 95634
Phone (530) 333-2548

1000 Fowler Way
Placerville, CA 95667
Phone (530) 295-8460

1004 Marshall Way
Placerville, CA 95667
Phone (530) 621-7777

1081 Marshall Way C
Placerville, CA 95667

1095 Marshall Way
Placerville, CA 95667
Phone (530) 626-2920

1095 Marshall Way
#100
Placerville, CA 95667
Phone (530) 626-2920

1095 Marshall Way
#201
Placerville, CA 95667
Phone (530) 344-5470

1095 Marshall Way
#202
Placerville, CA 95667
Phone (530) 626-3682

1095 Marshall Way
Fl 2
Placerville, CA 95667
Phone (530) 344-5470

3191 Turner St
Placerville, CA 95667

4300 Golden Center Dr
Ste A
Placerville, CA 95667
Phone (530) 344-2020

4341 Golden Center Dr
#A
Placerville, CA 95667
Phone (530) 626-1144

4341 Golden Center Dr
#B
Placerville, CA 95667

681 Main St
Ste 102
Placerville, CA 95667

681 Main St
Ste 206
Placerville, CA 95667
Phone (530) 626-2789

699 Main St
Ste C
Placerville, CA 95667
Phone (530) 295-8460

941 Spring St
Ste 1A
Placerville, CA 95667
Phone (530) 626-3682

941 Spring St
Ste A
Placerville, CA 95667
Phone (530) 295-6100

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Divide Wellness CenterGeorgetown, CA, CCN 058514 Rural health clinic Operational/Managerial Control Jun 1, 2009

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 188

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 188

NPI Registry JSON

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

{
    "created_epoch": "1742169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773792000000",
    "number": "1114727377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 45680",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941450680",
            "telephone_number": "530-626-2618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 TOWN CENTER BLVD BLDG D",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957627100",
            "telephone_number": "916-933-8010",
            "fax_number": "530-748-0322"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1111 Sierra At Tahoe Rd",
            "address_purpose": "LOCATION",
            "city": "Twin Bridges",
            "state": "CA",
            "postal_code": "957359505",
            "country_code": "US",
            "telephone_number": "530-622-1441",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4300 Golden Center Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Placerville",
            "state": "CA",
            "postal_code": "956676278",
            "country_code": "US",
            "telephone_number": "530-344-2020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MARSHALL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-17",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "SIRI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "530-622-1144"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marshall Multispeciality TCW",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Marshall Multispeciality TCW",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Marshall Vision Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in El Dorado Hills, CA

Sources for this page

Verify at the official NPI Registry.