Individual provider Active NPI

Marc M Kerner, MD

  • Specialist
  • Northridge, CA
National Provider Identifier
1275565608
Registry record updated Jan 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G69740 Issued in CA
Practice address
18350 Roscoe Blvd Ste 318
Northridge, CA 91325-4164
Phone
(818) 349-0600
Fax
(818) 993-0937
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G69740 CA Primary

Addresses

Primary practice location

18350 Roscoe Blvd Ste 318
Northridge, CA 91325-4164

Mailing address

18350 Roscoe Blvd Ste 318
Northridge, CA 91325-4164
Phone (818) 349-0600

Other identifiers 1

IdentifierTypeStateIssuer
95-4561883OtherCATAX ID#

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
I20060114000084 CA Practitioner - Otolaryngology 6608890835 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of California, Geffen School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

18350 Roscoe Blvd
Suite 318
Northridge, CA 91325-4164
Phone (818) 349-0600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.7 of 100Reported as individual
Quality
75.4
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G69740CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Northridge Facial Plastic Surgery Medical Group a Professional Corp Current Accepting new patients
Marc M Kerner M D Apc Specialist CurrentSince Dec 7, 2012 Accepting new patients
Dignity Community Care Past Accepting new patients
West Hills Hospital Past Accepting new patients

Locations

18350 Roscoe Blvd
Ste 318
Northridge, CA 91325
Phone (818) 349-0600

696 Hampshire Rd
Ste 110
Westlake Vlg, CA 91361
Phone (805) 230-1111

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231804800000",
    "number": "1275565608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18350 ROSCOE BLVD STE 318",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913254164",
            "telephone_number": "818-349-0600",
            "fax_number": "818-993-0937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18350 ROSCOE BLVD STE 318",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913254164",
            "telephone_number": "818-349-0600",
            "fax_number": "818-993-0937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERNER",
        "first_name": "MARC",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2009-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G69740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID#",
            "identifier": "95-4561883",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

Verify at the official NPI Registry.