Active NPI
Marc Nielsen, DO
- Family Medicine Physician
- Susanville, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 20A 10672
- Practice address
- 795 Joaquin St
Susanville, CA 96130-3628 - Phone
- (530) 257-2542
- NPI assigned
- Feb 25, 2008
- Last updated
- Sep 21, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 20A 10672 | CA | Primary |
Addresses
Primary practice location
795 Joaquin St
Susanville, CA 96130-3628
Mailing address
PO Box 476
Chester, CA 96020-0476
Phone (925) 324-5062
Other practice location 1
1800 Spring Ridge Dr
Susanville, CA 96130-6100
Phone (530) 252-2000
Other practice location 2
500 1st Ave
Portola, CA 96122-9406
Phone (530) 832-6500
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Seneca Healthcare District
Practice addresses (Care Compare)
130 Brentwood Dr
Chester, CA 96020
Phone (530) 258-2067
480 1St Ave
Portola, CA 96122-9405
Phone (530) 832-6600
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A 10672 | CA | MD | Family Medicine Physician |
| 10672 | CA | MD | Speech-Language Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sierra ER Department Physicians Medical Group Inc. | Current | Accepting new patients | |
| Eastern Plumas Health Care Home Health | Current | Accepting new patients | |
| Eastern Plumas Health Care District | Current | Accepting new patients |
Locations
480 1st Ave
Portola, CA 96122
Phone (530) 832-6600
500 1st Ave
Portola, CA 96122
Phone (530) 832-4277
1065 Bucks Lake Rd
Quincy, CA 95971
Phone (530) 283-2121
1800 Spring Ridge Dr
Susanville, CA 96130
Phone (530) 252-2225
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.
-
- Critical Access Hospital
- Portola, CA
- NPI 1245236850
-
- Emergency Medicine Physician
- Susanville, CA
- NPI 1033570247
-
- Medicare Defined Swing Bed Hospital Unit
- Chester, CA
- NPI 1326234022
-
- Critical Access Hospital
- Chester, CA
- NPI 1396848677
-
- Home Health Agency
- Portola, CA
- NPI 1043216849
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Eastern Plumas Health Care
- Critical Access Hospital
- Portola, CA
- NPI 1326044140
-
dba Eastern Plumas Health Care
- Critical Access Hospital
- Portola, CA
- NPI 1982600920
-
- Home Health Agency
- Quincy, CA
- NPI 1306873351
-
- Critical Access Hospital
- Chester, CA
- NPI 1215116629
-
- Critical Access Hospital
- Chester, CA
- NPI 1396848677
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537488000000",
"number": "1265601207",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 476",
"city": "CHESTER",
"state": "CA",
"postal_code": "960200476",
"telephone_number": "925-324-5062"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "795 JOAQUIN ST",
"city": "SUSANVILLE",
"state": "CA",
"postal_code": "961303628",
"telephone_number": "530-257-2542"
}
],
"practiceLocations": [
{
"address_1": "1800 Spring Ridge Dr",
"address_purpose": "LOCATION",
"city": "Susanville",
"state": "CA",
"postal_code": "961306100",
"country_code": "US",
"telephone_number": "530-252-2000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "500 1st Ave",
"address_purpose": "LOCATION",
"city": "Portola",
"state": "CA",
"postal_code": "961229406",
"country_code": "US",
"telephone_number": "530-832-6500",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NIELSEN",
"first_name": "MARC",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-02-25",
"last_updated": "2018-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "20A 10672",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Susanville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2018; 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.