Mary Anne Arcilla Tablizo, MD

Primary specialty

Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X

License

A76613 Issued in CA

Practice address

725 Welch Rd
Palo Alto, CA 94304-1601

Phone

(650) 497-8000

NPI assigned

Jan 22, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mtablizo17725@valleychildrens-prd.direct-ci.com

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.

• LPCH Medical Group Div of Lucile

  • Children's Hospital
  • Palo Alto, CA
  • NPI 1417907940

  Pediatrics

  Medicare reassignment NPD
• Valley Children'S Medical Group

  • Pediatrics Physician
  • Modesto, CA
  • NPI 1437555265
  Medicare reassignment NPD
• Doctors Medical Center of Modesto, Inc.

  • General Acute Care Hospital
  • Modesto, CA
  • NPI 1184654923
  NPD (past)
• Lucile Salter Packard Children'S Hospital at Stanford

  • Children's Hospital
  • Palo Alto, CA
  • NPI 1467442749
  NPD (past)
• Valley Children'S Hospital

  • Children's Hospital
  • Madera, CA
  • NPI 1952312043
  NPD (past)
• Ahs Hospital Corp.

  • General Acute Care Hospital
  • Summit, NJ
  • NPI 1740254143
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1295889905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 WELCH RD",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041601",
            "telephone_number": "650-497-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 WELCH RD",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041601",
            "telephone_number": "650-497-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABLIZO",
        "first_name": "MARY ANNE",
        "middle_name": "ARCILLA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A76613",
            "primary": false
        },
        {
            "code": "2080S0012X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sleep Medicine",
            "state": "CA",
            "license": "A76613",
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "CA",
            "license": "A76613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "A76613",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PROVIDER NUMBER",
            "identifier": "GR0103350",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara Jane Szkola, M.D.
• Joseph Quoc Ta, MD
• Theresa Ta, D.D.S.
• Seena Tabibi
• Juliet Marie Tablak, D.C.
• Wanda Eileen Tacey
• Theresa Ann Tacy, M.D.
• Matthew Jung Tae, MD
• Wesley William Taft, MD
• Jennifer Tagatz, RN, MSN, FNP-BC

• Pediatric Pulmonology Physician in Palo Alto, CA
• Providers in Palo Alto, CA by specialty
• Pediatric Pulmonology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.