Marissa L Andres-Kim, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A118959 Issued in CA

Practice address

20151 Nordhoff St
Chatsworth, CA 91311-6215

Phone

(818) 407-3200

Fax

(818) 775-4552

NPI assigned

May 29, 2009

Last updated

Nov 18, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Marissa L Andres Former name

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

Specialty

Psychiatry

Education

University of California, Davis School of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Los Angeles County Department of Mental HealthGroup PAC ID 7416869896, 294 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Los Angeles County Department of Mental Health

  dba GENESIS Countywide Older Adult Program

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Los Angeles, CA
  • NPI 1083633929
  Medicare reassignment Care Compare group NPD
• Los Angeles County Department of Mental Health

  dba Arcadia Mental Health Center-Full Service Partnership

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Arcadia, CA
  • NPI 1902676075
  NPD

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

{
    "created_epoch": "1243555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1376779744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20151 NORDHOFF ST",
            "city": "CHATSWORTH",
            "state": "CA",
            "postal_code": "913116215",
            "telephone_number": "818-407-3200",
            "fax_number": "818-775-4552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20151 NORDHOFF ST",
            "city": "CHATSWORTH",
            "state": "CA",
            "postal_code": "913116215",
            "telephone_number": "818-407-3200",
            "fax_number": "818-775-4552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRES-KIM",
        "first_name": "MARISSA",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-29",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "CA",
            "license": "A118959",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A118959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISSA",
            "last_name": "ANDRES",
            "middle_name": "L",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Americas Hospice, Inc
• Americo Home Health Agency Inc
• Farideh Amin, DDS
• Ann Nicole Ringpis Ancanan, REGISTERED NURSE
• Laura Andrade
• Angel S Visit Home Health
• Angelic Touch Hospice
• Angels Visit Hospice
• Liliana Anguiano, M.ED
• Elena I Angulo, MSW

• Psychiatry Physician in Chatsworth, CA
• Providers in Chatsworth, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; 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.