Individual provider Active NPI

Mercedes F. Maruscak, N.P.

  • Hematology & Oncology Physician
  • Glendale, CA
National Provider Identifier
1154356699
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
NP13515 Issued in CA
Practice address
222 W Eulalia St
100-B
Glendale, CA 91204-2849
Phone
(818) 637-7611
Fax
(818) 637-5106
NPI assigned
Jul 12, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X NP13515 CA Primary

Addresses

Primary practice location

222 W Eulalia St
100-B
Glendale, CA 91204-2849

Mailing address

10844 Rose Ave
#7
Los Angeles, CA 90034-5316
Phone (310) 815-8836

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP13515CAMDHematology & Oncology Physician
13515CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Shores Medical Group, Inc. Hematology & Oncology Past Accepting new patients
City of Hope Medical Foundation Hematology & Oncology PastSince Aug 8, 2021 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154356699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10844 ROSE AVE",
            "address_2": "#7",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900345316",
            "telephone_number": "310-815-8836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 W EULALIA ST",
            "address_2": "100-B",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042849",
            "telephone_number": "818-637-7611",
            "fax_number": "818-637-5106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARUSCAK",
        "first_name": "MERCEDES",
        "middle_name": "F.",
        "name_prefix": "Ms.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "NP13515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.