Individual provider Active NPI

Mariah C Grace, D.O

  • Obstetrics & Gynecology Physician
  • Fresno, CA
National Provider Identifier
1164727368
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
20A12329 Issued in CA
Practice address
150 North Fresno Stree
Fresno, CA 93701
Phone
(559) 459-3934
NPI assigned
Jan 19, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 20A12329 CA Primary

Addresses

Primary practice location

150 North Fresno Stree
Fresno, CA 93701

Mailing address

1804 Embarcadero Rd
Ste 100
Palo Alto, CA 94303-3341

Other practice location 1

332 Santa Fe Dr Ste 115
Encinitas, CA 92024-5143
Phone (760) 901-5155

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
I20141216001680 CA Practitioner - Obstetrics/Gynecology 8224351663 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scripps HealthGroup PAC ID 9234033853, 1,450 clinicians

Practice addresses (Care Compare)

332 Santa Fe Dr
Suite 115
Encinitas, CA 92024-5143
Phone (760) 901-5155

4318 Mission Ave
Oceanside, CA 92057-6541
Phone (760) 901-5100

9888 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 626-4123

9896 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 626-4123

9898 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 455-9100

Hospital & facility affiliations

  • Scripps Memorial Hospital - Encinitas Hospital, Encinitas, CA, CCN 050503

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 Osteopathy

State licenses

LicenseStateTypeSpecialty
20A12329CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Obstetrics & Gynecology Current Accepting new patients
Scripps Health Current Accepting new patients
University Healthcare Alliance Obstetrics & Gynecology CurrentSince Oct 1, 2014 Accepting new patients
Scripps Health Obstetrics & Gynecology CurrentSince Jan 1, 2020 Accepting new patients
Stanford Health Care CurrentSince Nov 12, 2014 Accepting new patients
Stanford Health Care Obstetrics & Gynecology Current Accepting new patients
LPCH Medical Group Div of Lucile CurrentSince Nov 21, 2014 Accepting new patients
Scripps Health Current Accepting new patients
Stanford Health Care Obstetrics & Gynecology CurrentSince Nov 12, 2014 Accepting new patients
Scripps Health CurrentSince Jan 1, 2020 Accepting new patients
Stanford Hospital and Clinics Past Accepting new patients
Obhg California, P.C. Obstetrics & Gynecology Past Accepting new patients
Scripps Health Past Accepting new patients
Lucile Salter Packard Children'S Hospital at Stanford Past Accepting new patients

Locations

332 Santa Fe Dr
Ste 115
Encinitas, CA 92024
Phone (760) 901-5155

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

File 54433
Los Angeles, CA 90074
Phone (858) 784-5645

321 Middlefield Rd
Ste 165
Menlo Park, CA 94025
Phone (650) 498-6500

1300 Crane St
Menlo Park, CA 94025
Phone (510) 785-5000

725 Welch Rd
Palo Alto, CA 94304
Phone (650) 497-8979

10790 Rancho Bernardo Rd
San Diego, CA 92127
Phone (858) 554-2626

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

Interoperability endpoints

  • Direct secure messaging: mgrace118193@direct.stanfordhealthcare.org
  • Direct secure messaging: mgrace321146@scrippshlth.medalliesdirect.net

Organizations & group practices 14

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 14

Hospital & facility affiliations 1

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": "1295395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1164727368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 EMBARCADERO RD",
            "address_2": "STE 100",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943033341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 NORTH FRESNO STREE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93701",
            "telephone_number": "559-459-3934"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "332 Santa Fe Dr Ste 115",
            "address_purpose": "LOCATION",
            "city": "Encinitas",
            "state": "CA",
            "postal_code": "920245143",
            "country_code": "US",
            "telephone_number": "760-901-5155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRACE",
        "first_name": "MARIAH",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-19",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "20A12329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.