Individual provider Active NPI

Marnie Jo Kremer Prill, MD

  • Diagnostic Radiology Physician
  • Newport Beach, CA
National Provider Identifier
1366694606
Registry record updated Jan 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A109358 Issued in CA
Practice address
One Hoag Drive
Newport Beach, CA 92663-4162
Phone
(949) 645-3534
NPI assigned
Oct 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A109358 CA Primary

Addresses

Primary practice location

One Hoag Drive
Newport Beach, CA 92663-4162

Mailing address

471 N. Old Newport #302
Newport Beach, CA 92633-4244
Phone (949) 645-3534

Other identifiers 2

IdentifierTypeStateIssuer
1366694606MedicaidCA
00A10935800OtherCABCBS OF CA

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
I20130807000459 CA Practitioner - Diagnostic Radiology 8022250828 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Maryland School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sharp Rees-Stealy Medical Group IncGroup PAC ID 8628972759, 872 clinicians

Practice addresses (Care Compare)

300 Fir St
San Diego, CA 92101-2327
Phone (848) 499-2600

Merit-based Incentive Payment System (MIPS)

Final score
88.67 of 100Reported as group
Quality
81.04
Promoting interoperability
99
Improvement activities
40
Cost
82.04

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
109358CAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Dec 7, 2015 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Dec 7, 2015 Accepting new patients
Newport Center Radiology Associates Medical Group Inc Diagnostic Radiology CurrentSince Nov 10, 2014 Accepting new patients
Stanford Hospital and Clinics Past Accepting new patients
Sharp Rees-Stealy Medical Center Past Accepting new patients
Sharp Memorial Hospital Past Accepting new patients

Locations

20 Executive Park
Ste 155
Irvine, CA 92614

360 San Miguel Dr
Ste 105
Newport Beach, CA 92660
Phone (949) 365-3534

360 San Miguel Dr
Ste 1
Newport Beach, CA 92660
Phone (949) 365-3534

1 Hoag Dr
Newport Beach, CA 92663
Phone (877) 742-4624

360 San Miguel Dr
Ste 105106
Newport Beach, CA 92660

Dept LA 21705
Pasadena, CA 91185

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

300 Fir St
San Diego, CA 92101
Phone (619) 446-1586

Interoperability endpoints

  • Direct secure messaging: mkremerprill114280@sharphealthcare.direct-ci.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1224201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421193600000",
    "number": "1366694606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "471 N. OLD NEWPORT #302",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926334244",
            "telephone_number": "949-645-3534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE HOAG DRIVE",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926634162",
            "telephone_number": "949-645-3534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREMER PRILL",
        "first_name": "MARNIE",
        "middle_name": "JO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-17",
        "last_updated": "2015-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A109358",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366694606",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF CA",
            "identifier": "00A10935800",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.