Marc Nielsen, DO
Individual provider Active NPI Family Medicine Physician · Susanville, CA
NPI 1265601207 · NPPES record last updated Sep 21, 2018
Key facts
- NPI
- 1265601207
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 20A 10672 (CA)
- Practice address
- 795 Joaquin St
Susanville, CA 96130-3628 - Phone
- (530) 257-2542
- NPI assigned
- Feb 25, 2008
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 12
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Seneca Healthcare District
Eastern Plumas Health Care 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
- Quincy Home Medical Services
- Seneca District Hospital
- Eastern Plumas Hospital - Portola Campus
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100319000560 | CA | Practitioner - Family Practice |
1557496247 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A 10672 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eastern Plumas Health Care Home Health | Current |
Accepting new patients | |
| Eastern Plumas Health Care District | Current |
Accepting new patients | |
| Sierra ER Department Physicians Medical Group Inc. | Current |
Accepting new patients |
Locations
500 1st Ave
Portola, CA 96122
Phone (530) 832-4277
480 1st Ave
Portola, CA 96122
Phone (530) 832-6600
1065 Bucks Lake Rd
Quincy, CA 95971
Phone (530) 283-2121
1800 Spring Ridge Dr
Susanville, CA 96130
Phone (530) 252-2225
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 20A 10672 | CA | Yes |
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
Other providers in Susanville, CA
- Aradala Marie Nelson
- Joshua Neubert
- Stephanie NG
- Pak Yan Ngai
- Ronnie Nicholas
- Richard Nielsen
- Timothy J Nolan
- Scott Douglas Nordstrom
- Sarah Jennifer North
- Northeastern Rural Health Clinics
All providers in Susanville, CA · Family Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 21, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.