Individual provider Active NPI

Marie J McGlynn, M.D.

  • Family Medicine Physician
  • Brentwood, CA
National Provider Identifier
1184654279
Registry record updated May 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A64911 Issued in CA
Practice address
3291 Walnut Blvd
Suite 100
Brentwood, CA 94513-4412
Phone
(925) 513-9495
Fax
(925) 626-3782
NPI assigned
Jul 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2013

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 A64911 CA Primary

Addresses

Primary practice location

3291 Walnut Blvd
Suite 100
Brentwood, CA 94513-4412

Mailing address

3291 Walnut Blvd
Suite 100
Brentwood, CA 94513-4412
Phone (925) 513-9495

Other identifiers 1

IdentifierTypeStateIssuer
00A649110MedicaidCA

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
I20090313000497 CA Practitioner - Family Practice 0345307542 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Temple University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Muir Family Physicians Medical Group, Inc.Group PAC ID 8820237316, 2 clinicians

Practice addresses (Care Compare)

3291 Walnut Blvd
Suite 100
Brentwood, CA 94513-4412
Phone (925) 513-9495

Hospital & facility affiliations

  • John Muir Home Health Services Home health agency, Concord, CA, CCN 057276
  • John Muir Medical Center - Walnut Creek Campus Hospital, Walnut Creek, CA, CCN 050180

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
64911CAMDPharmacist
A64911CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Muir Family Physicians Medical Group Inc. Family Medicine CurrentSince Jun 1, 2013 Accepting new patients
John Muir Health Past Accepting new patients
John Muir Health Past Accepting new patients

Locations

3291 Walnut Blvd
Ste 100
Brentwood, CA 94513
Phone (925) 513-9495

Interoperability endpoints

  • Direct secure messaging: mmcglynn8254@ehr.johnmuirhealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369872000000",
    "number": "1184654279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3291 WALNUT BLVD",
            "address_2": "SUITE 100",
            "city": "BRENTWOOD",
            "state": "CA",
            "postal_code": "945134412",
            "telephone_number": "925-513-9495",
            "fax_number": "925-626-3782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3291 WALNUT BLVD",
            "address_2": "SUITE 100",
            "city": "BRENTWOOD",
            "state": "CA",
            "postal_code": "945134412",
            "telephone_number": "925-513-9495",
            "fax_number": "925-626-3782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGLYNN",
        "first_name": "MARIE",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2013-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A64911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A649110",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, CA

Sources for this page

Verify at the official NPI Registry.