Individual provider Active NPI

Marielle Anne S Ngo, CRNA

  • Certified Registered Nurse Anesthetist
  • Los Angeles, CA
National Provider Identifier
1255036349
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
152004 Issued in CA
Practice address
1500 San Pablo St FL 4
Los Angeles, CA 90033-5313
Phone
(323) 442-7400
NPI assigned
Mar 30, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 95143817 CA
Certified Registered Nurse Anesthetist 367500000X 152004 CA Primary

Addresses

Primary practice location

1500 San Pablo St FL 4
Los Angeles, CA 90033-5313

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 442-7400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250212001881 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 3173053790 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Usc Care Medical Group IncGroup PAC ID 0446157747, 1,378 clinicians
Genesis Healthcare Partners PCGroup PAC ID 2163606807, 232 clinicians

Practice addresses (Care Compare)

1441 Eastlake Ave
Suite 2424
Los Angeles, CA 90089-0112
Phone (323) 442-2582

1500 San Pablo St
Los Angeles, CA 90033-5313
Phone (323) 442-8444

1516 San Pablo St
Los Angeles, CA 90033-5313
Phone (800) 872-2273

1520 San Pablo St
Los Angeles, CA 90033-5310
Phone (800) 872-2273

1520 San Pablo St 1St Floor N
Los Angeles, CA 90033-5310
Phone (800) 872-2273

50 Alessandro PL
Suite 410
Pasadena, CA 91105-3175
Phone (626) 793-7114

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95143817CAMDCritical Care Medicine Registered Nurse
95002545CAMDPediatric Nurse Practitioner
152004CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc CurrentSince Feb 1, 2025 Accepting new patients
Genesis Healthcare Partners PC CurrentSince Jun 1, 2025 Accepting new patients
Skyline Urology Current Accepting new patients
Usc Care Medical Group, Inc CurrentSince Feb 1, 2025 Accepting new patients
Urology Institute of the South Bay Current Accepting new patients
Amsurg Arcadia Anesthesia LP CurrentSince Feb 1, 2025 Accepting new patients

Locations

488 E Santa Clara St
Ste 102
Arcadia, CA 91006
Phone (626) 359-9555

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

9850 Genesee Ave
Ste 440
La Jolla, CA 92037
Phone (858) 453-5944

1500 San Pablo St
Fl 4
Los Angeles, CA 90033

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

50 Alessandro Pl
Ste 410
Pasadena, CA 91105
Phone (626) 793-7114

23600 Telo Ave
Ste 220
Torrance, CA 90505
Phone (310) 534-8400

Organizations & group practices 6

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 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": "1680134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740960000000",
    "number": "1255036349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "323-442-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 SAN PABLO ST FL 4",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335313",
            "telephone_number": "323-442-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGO",
        "first_name": "MARIELLE ANNE",
        "middle_name": "S",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-30",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "CA",
            "license": "95143817",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "152004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.