Individual provider Active NPI

Maria Roxanne Aileen Ventenilla Arcinue, MD

  • Neonatal-Perinatal Medicine Physician
  • Tarzana, CA
National Provider Identifier
1174787931
Registry record updated Jul 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
A112597 Issued in CA
Practice address
18321 Clark St
Tarzana, CA 91356-3501
Phone
(818) 881-0800
NPI assigned
Jul 10, 2008
Last updated
Jul 8, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 57013888 OH
Neonatal-Perinatal Medicine Physician 2080N0001X A112597 CA Primary

Addresses

Primary practice location

18321 Clark St
Tarzana, CA 91356-3501

Mailing address

3701 Wilshire Blvd
Ste 600
Los Angeles, CA 90010-2804
Phone (323) 361-2337

Other practice location 1

4650 W Sunset Blvd
Los Angeles, CA 90027-6062
Phone (323) 361-4100

Other names 1

  • Roxanne Arcinue Former name

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
I20160726002390 CA Practitioner - Critical Care (Intensivists)Practitioner - Pediatric Medicine 8426292681 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A112597CAMDFamily Medicine Physician
57013888OHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital Los Angeles Medical Group, Inc. Pediatrics CurrentSince Jul 1, 2016 Accepting new patients
Cedars-Sinai Medical Care Foundation CurrentSince Jul 1, 2020 Accepting new patients
Cedars-Sinai Medical Center CurrentSince Jul 1, 2020 Accepting new patients
Cedars-Sinai Medical Center CurrentSince Jul 1, 2020 Accepting new patients

Locations

3701 Wilshire Blvd
Ste 600
Los Angeles, CA 90010
Phone (323) 361-3550

4650 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 361-2122

8635 W 3rd St
Ste 465W
Los Angeles, CA 90048
Phone (310) 423-0674

18321 Clark St
Tarzana, CA 91356
Phone (310) 423-6744

4140 W 190th St
Torrance, CA 90504
Phone (310) 967-1780

8700 Beverly Blvd
West Hollywood, CA 90048
Phone (310) 385-3291

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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.

NPI Registry JSON

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594166400000",
    "number": "1174787931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 WILSHIRE BLVD",
            "address_2": "STE 600",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900102804",
            "telephone_number": "323-361-2337",
            "fax_number": "323-361-8491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18321 CLARK ST",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563501",
            "telephone_number": "818-881-0800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4650 W Sunset Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900276062",
            "country_code": "US",
            "telephone_number": "323-361-4100",
            "fax_number": "323-361-3642",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ARCINUE",
        "first_name": "MARIA ROXANNE AILEEN",
        "middle_name": "VENTENILLA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-10",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "57013888",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "CA",
            "license": "A112597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROXANNE",
            "last_name": "ARCINUE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tarzana, CA

Sources for this page

Verify at the official NPI Registry.