Individual provider Active NPI

Marcelino Arenas, PA-C

  • Family Medicine Physician
  • Anaheim, CA
National Provider Identifier
1184622862
Registry record updated Mar 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
PA147806 Issued in CA
Practice address
1211 W la Palma Ave
Suite 207
Anaheim, CA 92801-2815
Phone
(714) 772-8282
Fax
(714) 772-6493
NPI assigned
Jul 7, 2005
Last updated
Mar 8, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X PA147806 CA Primary

Addresses

Primary practice location

1211 W la Palma Ave
Suite 207
Anaheim, CA 92801-2815

Mailing address

1211 W la Palma Ave
Suite 207
Anaheim, CA 92801-2815
Phone (714) 772-8282

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050405001440 CA Practitioner - Physician Assistant 5597712166 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

13522 Newport Ave
Suite 102
Tustin, CA 92780-3707
Phone (714) 573-8200

999 N Tustin Ave
Suite 1
Santa Ana, CA 92705-3530
Phone (714) 836-6800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA147806CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chest and Critical Care Consultants a Medical Group CurrentSince Jul 10, 2015 Accepting new patients
Chest and Critical Care Consultants CurrentSince Jul 10, 2015 Accepting new patients
Crown City Medical Group, Inc. Family Medicine Past Accepting new patients
Altamed Health Services Corporation Past Accepting new patients
Marian a. Fedak M.D. Medical Corporation Past Accepting new patients

Locations

1211 W La Palma Ave
Ste 207
Anaheim, CA 92801
Phone (714) 772-8282

1211 W La Palma Ave
Ste 404
Anaheim, CA 92801
Phone (714) 772-1030

999 N Tustin Ave
Ste 1
Santa Ana, CA 92705
Phone (714) 836-6800

13522 Newport Ave
Ste 102
Tustin, CA 92780
Phone (714) 573-8200

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331164800000",
    "number": "1184622862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 W LA PALMA AVE",
            "address_2": "SUITE 207",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928012815",
            "telephone_number": "714-772-8282",
            "fax_number": "714-772-6493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 W LA PALMA AVE",
            "address_2": "SUITE 207",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928012815",
            "telephone_number": "714-772-8282",
            "fax_number": "714-772-6493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARENAS",
        "first_name": "MARCELINO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2012-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "PA147806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.