Marjorie M. Chan, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

20829 Issued in CA

Practice address

3090 Bristol St Ste 200
Costa Mesa, CA 92626-3061

Phone

(888) 789-9585

Fax

(562) 803-4500

NPI assigned

Jul 19, 2011

Last updated

Nov 3, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Marjorie S. Manzanilla Former name

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Care Partners California Medical PCGroup PAC ID 5799290987, 20 clinicians

GN Medical Associates, IncGroup PAC ID 5092605816, 40 clinicians

Careconnectmd Ca PCGroup PAC ID 5496178055, 30 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Al-Shifa Home Health Care Agency Home health agency, Anaheim, CA, CCN 559385

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Care Partners California Medical PC

  • Geriatric Medicine (Family Medicine) Physician
  • Costa Mesa, CA
  • NPI 1669260493
  Medicare reassignment Care Compare group NPD
• Careconnectmd Ca PC

  • Family Medicine Physician
  • Costa Mesa, CA
  • NPI 1366063125
  Medicare reassignment Care Compare group NPD
• Thrive Healthcare Solutions Nursing PC

  • Nurse Practitioner
  • Anaheim, CA
  • NPI 1851192371
  Medicare reassignment NPD Authorized official
• GN Medical Associates, Inc.

  dba Gerinet Medical Associates

  • Family Medicine Physician
  • Costa Mesa, CA
  • NPI 1275576522
  Medicare reassignment Care Compare group
• Anthem Medical Specialists Inc

  • Nursing Care Agency
  • Orange, CA
  • NPI 1740003714
  Medicare reassignment NPD
• Carequest Solutions Nursing PC

  • Internal Medicine Physician
  • Anaheim, CA
  • NPI 1497560858

  Nurse Practitioner

  Medicare reassignment NPD
• Concertocare Medical Group of California, P.C.

  • Internal Medicine Physician
  • Huntington Beach, CA
  • NPI 1922777259
  Medicare reassignment NPD
• Concierge Healthcare Services

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1649142282

  Nurse Practitioner

  Medicare reassignment NPD
• FM Woundcare Inc

  • General Practice Physician
  • Lomita, CA
  • NPI 1982409579

  Nurse Practitioner

  Medicare reassignment NPD
• Prudent Healthcare Services Nursing

  • Internal Medicine Physician
  • Anaheim, CA
  • NPI 1770326969

  Nurse Practitioner

  Medicare reassignment NPD
• Carelon Medical Partners, PC

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Nashville, TN
  • NPI 1124443403

  Nurse Practitioner

  NPD (past)
• Caremore Health Medical Partners, PC

  • Internal Medicine Physician
  • Indianapolis, IN
  • NPI 1124640503
  NPD (past)

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

• Al-Shifa Home Health Care Agency

  • Home Health Agency
  • Anaheim, CA
  • NPI 1457916819
  Care Compare affiliation

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

{
    "created_epoch": "1311033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1174811624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3090 BRISTOL ST STE 200",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926263061",
            "telephone_number": "714-619-8777",
            "fax_number": "714-619-8770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3090 BRISTOL ST STE 200",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926263061",
            "telephone_number": "888-789-9585",
            "fax_number": "562-803-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "MARJORIE",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-19",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "20829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARJORIE",
            "last_name": "MANZANILLA",
            "middle_name": "S.",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jean Champion, MA, CCC-SLP
• Treavor Champion
• Stephenie R Champlin, MSW, LCSW
• Courtney Paige Chan, RN
• Kayla Chan
• Kevin Kethya Chanda
• Vidhi Chandnani
• Alexander George Chang, DPT
• CHI Chang, OD
• Gina Chang, PH.D, BCBA-D

• Nurse Practitioner in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.