Mario Alfredo Martinez Chavez

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95000992 Issued in CA

Practice address

1225 Wilshire Blvd
Los Angeles, CA 90017-1901

Phone

(213) 977-2423

NPI assigned

Jul 25, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Can Emergency Physicians Medical Group IncGroup PAC ID 8820304462, 49 clinicians

Glendale Adventist Emergency Physicians IncorporatedGroup PAC ID 1254563869, 26 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Glendale Adventist Medical Center Hospital, Glendale, CA, CCN 050239

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Can Emergency Physicians Medical Group, Inc.

  • Emergency Medicine Physician
  • Panorama City, CA
  • NPI 1265810006
  Medicare reassignment Care Compare group NPD
• Glendale Adventist Emergency Physicians Incorporated

  • Emergency Medicine Physician
  • Glendale, CA
  • NPI 1679907869
  Medicare reassignment Care Compare group NPD
• Can Emergency Physicians Medical Group Inc

  • Emergency Medicine Physician
  • Tustin, CA
  • NPI 1386018356
  NPD
• First Aid Urgent Care Inc

  • Urgent Care Clinic/Center
  • Tujunga, CA
  • NPI 1760889190
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Glendale Adventist Medical Center

  • General Acute Care Hospital
  • Glendale, CA
  • NPI 1831188275
  Care Compare affiliation

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

{
    "created_epoch": "1406246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406246400000",
    "number": "1326456120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 N ALEXANDER ST",
            "city": "SAN FERNANDO",
            "state": "CA",
            "postal_code": "913402002",
            "telephone_number": "818-970-9258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 WILSHIRE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171901",
            "telephone_number": "213-977-2423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVEZ",
        "first_name": "MARIO ALFREDO",
        "middle_name": "MARTINEZ",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-25",
        "last_updated": "2014-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95000992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Manuel James Chavez, OTR/L
• Margarita Chavez, SLP-CFY
• Maria Chavez
• Maria C Chavez
• Maria Eugenia Chavez, RN
• Mary Catherine Chavez
• Michael Chavez
• Miguel Chavez, L.C.S.W.
• Mireya Chavez, RN
• Nidia Giselle Chavez

• Nurse Practitioner in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2014; 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.

Verify at the official NPI Registry.