Individual provider Active NPI

Michael E Marrero, M.D.

  • Diagnostic Radiology Physician
  • El Segundo, CA
National Provider Identifier
1346288669
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME131980 Issued in FL
Practice address
2330 Utah Ave Ste 200
El Segundo, CA 90245-4817
Phone
(281) 766-0959
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 73844 MA
Diagnostic Radiology Physician 2085R0202X ME131980 FL Primary

Addresses

Primary practice location

2330 Utah Ave Ste 200
El Segundo, CA 90245-4817

Mailing address

PO Box 1849
Lewiston, ME 04241-1849
Phone (207) 784-2554

Other practice location 1

5 Alumni Drive
Exeter, NH 03833-2128
Phone (603) 580-6608

Other identifiers 7

IdentifierTypeStateIssuer
0109754Y0NH02OtherNHANTHEM
300134039OtherRAILROAD MEDICARE
3078337MedicaidMA
4276160OtherAETNA
292780099MedicaidME
30203233MedicaidNH
3405042OtherCIGNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050803000366 NH Practitioner - Diagnostic Radiology 4789653569 Reassigns benefits to 2 organizations
I20230809000239 FL Practitioner - Diagnostic Radiology 4789653569 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mori Bean and Brooks IncGroup PAC ID 8820077878, 966 clinicians
Intercoastal Medical Group IncGroup PAC ID 6305730912, 176 clinicians

Practice addresses (Care Compare)

1063 Bahia Vista CT
Sarasota, FL 34232-2403
Phone (904) 399-5550

11505 Rangeland Pkwy
Bradenton, FL 34211-4041
Phone (941) 907-6016

1700 S Tamiami TRL
Sarasota, FL 34239-3509
Phone (904) 399-5550

1880 Loma Linda St
Sarasota, FL 34239-2205
Phone (904) 399-5550

1941 Waldemere St
Cape Surgery Center
Sarasota, FL 34239-2922
Phone (904) 399-5550

2001 Kingsley Ave
Orange Park, FL 32073-5148
Phone (904) 399-5550

2115 Little Rd
Trinity, FL 34655-4410
Phone (904) 399-5550

2600 Laurel Rd E
Nokomis, FL 34275-3226
Phone (904) 399-5550

2881 Hyde Park St
Sarasota, FL 34239-3228
Phone (941) 906-7155

3050 NE 164TH St
Miami, FL 33160-4131
Phone (904) 399-5550

3333 Cattlemen Rd
Sarasota, FL 34232-6057

5880 Rand Blvd
Sarasota, FL 34238-5118
Phone (904) 399-5550

921 S Beneva Rd
Sarasota, FL 34232-2401
Phone (941) 365-7390

943 S Beneva Rd
FL 1
Sarasota, FL 34232-2476
Phone (941) 955-6748

943 S Beneva Rd
Suite 113
Sarasota, FL 34232-2471
Phone (941) 316-0133

965 S Beneva Rd
Sarasota, FL 34232-2401
Phone (941) 366-1888

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.36 of 100Reported as apm
Quality
85.92
Promoting interoperability
78
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
91.52 of 100Reported as group
Quality
93.8
Improvement activities
40
Cost
79.98

Merit-based Incentive Payment System (MIPS)

Final score
78.06 of 100Reported as group
Quality
72.79
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME131980FLMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Diagnostic Imaging, PLLC Diagnostic Radiology CurrentSince Jul 17, 1997 Accepting new patients
Core Physicians LLC CurrentSince Sep 27, 2019 Accepting new patients
Intercoastal Medical Group Inc CurrentSince Aug 13, 2025 Accepting new patients
Providence Diagnostic Imaging, Inc. Diagnostic Radiology CurrentSince Dec 19, 2023 Accepting new patients
Core Physicians, LLC CurrentSince Sep 27, 2019 Accepting new patients
Mori Bean and Brooks Inc Diagnostic Radiology CurrentSince Apr 29, 2023 Accepting new patients

Locations

2330 Utah Ave
#200
El Segundo, CA 90245
Phone (281) 766-9059

2001 Kingsley Ave
Orange Park, FL 32073
Phone (904) 215-7015

943 S Beneva Rd
Ste 306
Sarasota, FL 34232
Phone (941) 362-8644

921 S Beneva Rd
Sarasota, FL 34232
Phone (941) 365-7390

13695 US Highway 1
Sebastian, FL 32958
Phone (772) 589-3185

2700 University Square Dr
Tampa, FL 33612
Phone (813) 251-5822

2115 Little Rd
Trinity, FL 34655
Phone 7278418225410

271 Carew St
Springfield, MA 01104
Phone (413) 748-9000

96 Calef Hwy
Unit 6
Epping, NH 03042
Phone (603) 679-5114

7 Holland Way
#1
Exeter, NH 03833

5 Alumni Dr
Exeter, NH 03833
Phone (603) 580-6339

3 Alumni Dr
Ste 301
Exeter, NH 03833
Phone (603) 658-1180

7 Alumni Dr
Exeter, NH 03833
Phone (603) 777-1000

127 Plaistow Rd
Plaistow, NH 03865
Phone (603) 382-4972

605 Lafayette Rd
Portsmouth, NH 03801
Phone (603) 427-6600

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 6

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 5

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1346288669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1849",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042411849",
            "telephone_number": "207-784-2554",
            "fax_number": "207-777-5363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 UTAH AVE STE 200",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902454817",
            "telephone_number": "281-766-0959"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5 Alumni Drive",
            "address_purpose": "LOCATION",
            "city": "Exeter",
            "state": "NH",
            "postal_code": "038332128",
            "country_code": "US",
            "telephone_number": "603-580-6608",
            "fax_number": "603-580-6707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARRERO",
        "first_name": "MICHAEL",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "73844",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME131980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "0109754Y0NH02",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "300134039",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3078337",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4276160",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "292780099",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30203233",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3405042",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Segundo, CA

Sources for this page

Verify at the official NPI Registry.