NPIMap

Individual provider Active NPI

Marcia Amelia Ciccone, MD

  • Obstetrics & Gynecology Physician
  • Glendale, CA
National Provider Identifier
1154672152
Registry record updated Aug 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A122851 Issued in CA
Practice address
1808 Verdugo Blvd Ste 413
Glendale, CA 91208-1468
Phone
(818) 658-5980
Fax
(323) 865-0062
NPI assigned
Oct 1, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecologic Oncology Physician 207VX0201X A122851 CA
Obstetrics & Gynecology Physician 207V00000X A122851 CA Primary

Addresses

Primary practice location

1808 Verdugo Blvd Ste 413
Glendale, CA 91208-1468

Mailing address

1516 San Pablo St FL 3
Los Angeles, CA 90033-5313
Phone (323) 865-3922

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address marcia.ciccone@direct.usc.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180728000070 CA Practitioner - Obstetrics/Gynecology 7810244498 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Southern California Keck School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Usc Care Medical Group IncGroup PAC ID 0446157747, 1,378 clinicians

Practice addresses (Care Compare)

1500 San Pablo St
Los Angeles, CA 90033-5313
Phone (323) 442-8444

1516 San Pablo St
Los Angeles, CA 90033-5313
Phone (800) 872-2273

1520 San Pablo St
Los Angeles, CA 90033-5310
Phone (800) 872-2273

1520 San Pablo St 1St Floor N
Los Angeles, CA 90033-5310
Phone (800) 872-2273

1808 Verdugo Blvd
Suite 413
Glendale, CA 91208-1468
Phone (818) 658-5980

1812 Verdugo Blvd
Glendale, CA 91208-1407
Phone (818) 790-7100

625 S Fair Oaks Ave
Pasadena, CA 91105-2684
Phone (626) 683-9000

Hospital & facility affiliations

  • Usc Kenneth Norris Jr Cancer Hospital Hospital, Los Angeles, CA, CCN 050660
  • Keck Hospital of Usc Hospital, Los Angeles, CA, CCN 050696
  • Los Angeles General Medical Center Hospital, Los Angeles, CA, CCN 050373
  • Usc Verdugo Hills Hospital Hospital, Glendale, CA, CCN 050124

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A122851CAMDObstetrics & Gynecology Physician

Practice roles (6 of 7)

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc CurrentSince Aug 1, 2018 Accepting new patients
Usc Care Medical Group, Inc Obstetrics & Gynecology CurrentSince Aug 1, 2018 Accepting new patients
Usc Verdugo Hills Hospital, LLC Past Accepting new patients
Usc University Hospital, Inc. Past Accepting new patients
Keck Medical Center of Usc Past Accepting new patients
Keck Medical Center of Usc PastSince Aug 23, 2020 Accepting new patients

Locations

1808 Verdugo Blvd
Ste 412
Glendale, CA 91208

1808 Verdugo Blvd
Ste 413
Glendale, CA 91208
Phone (818) 658-5980

1500 San Pablo St
Los Angeles, CA 90033
Phone (323) 443-8500

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

1516 San Pablo St
Fl 3
Los Angeles, CA 90033
Phone (323) 276-3705

1516 San Pablo St
Los Angeles, CA 90033
Phone (323) 276-3705

625 S Fair Oaks Ave
Ste 400
Pasadena, CA 91105
Phone (626) 568-1622

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1349049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597881600000",
    "number": "1154672152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1516 SAN PABLO ST FL 3",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335313",
            "telephone_number": "323-865-3922",
            "fax_number": "323-865-0062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1808 VERDUGO BLVD STE 413",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912081468",
            "telephone_number": "818-658-5980",
            "fax_number": "323-865-0062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CICCONE",
        "first_name": "MARCIA",
        "middle_name": "AMELIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-01",
        "last_updated": "2020-08-20",
        "certification_date": "2020-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "CA",
            "license": "A122851",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A122851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "marcia.ciccone@direct.usc.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1808 Verdugo Blvd Ste 413",
            "city": "Glendale",
            "state": "CA",
            "country_code": "US",
            "postal_code": "912081468",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.