Individual provider Active NPI

Marianne N. Verma, MD

  • Family Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1356592927
Registry record updated Oct 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
40426 Issued in AZ
Practice address
2601 E Roosevelt St
Phoenix, AZ 85008-4973
Phone
(602) 470-5000
Fax
(602) 470-5064
NPI assigned
Oct 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 40426 AZ Primary

Addresses

Primary practice location

2601 E Roosevelt St
Phoenix, AZ 85008-4973

Mailing address

2929 E Thomas Rd
Phoenix, AZ 85016-8034
Phone (602) 470-5043

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
I20221222000300 CA Practitioner - Family Practice 4082774898 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeside Medical Organization a Medical Group IncGroup PAC ID 7618005166, 64 clinicians

Practice addresses (Care Compare)

191 S Buena Vista St
Suite 150
Burbank, CA 91505-4522
Phone (818) 295-5920

Merit-based Incentive Payment System (MIPS)

Final score
80.57 of 100Reported as group
Quality
62.42
Promoting interoperability
76
Improvement activities
40
Cost
76.15

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeside Medical Organization, a Medical Group Inc. Family Medicine CurrentSince Oct 11, 2022 Accepting new patients

Locations

191 S Buena Vista St
Ste 200
Burbank, CA 91505
Phone (818) 887-2671

191 S Buena Vista St
Ste 150
Burbank, CA 91505
Phone (818) 295-5920

8510 Balboa Blvd
Ste 150
Northridge, CA 91325
Phone (818) 637-2000

Interoperability endpoints

  • Direct secure messaging: marianne.verma.p1@direct.lakeside.nextgenshare.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1222819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222819200000",
    "number": "1356592927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2929 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850168034",
            "telephone_number": "602-470-5043",
            "fax_number": "602-470-5064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 E ROOSEVELT ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850084973",
            "telephone_number": "602-470-5000",
            "fax_number": "602-470-5064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERMA",
        "first_name": "MARIANNE",
        "middle_name": "N.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-01",
        "last_updated": "2008-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "40426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.