Individual provider Active NPI

Marek Zdarzyl, M.D.

  • Family Medicine Physician
  • Glendale, CA
National Provider Identifier
1386618270
Registry record updated Sep 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A48707 Issued in CA
Practice address
1818 Verdugo Blvd
Suite 407
Glendale, CA 91208-1403
Phone
(818) 952-7251
Fax
(818) 952-7256
NPI assigned
Feb 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A48707 CA Primary
Internal Medicine Physician 207R00000X A48707 CA

Addresses

Primary practice location

1818 Verdugo Blvd
Suite 407
Glendale, CA 91208-1403

Mailing address

1818 Verdugo Blvd
Suite 407
Glendale, CA 91208-1403
Phone (818) 952-7251

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
I20120131000907 CA Practitioner - Internal MedicinePractitioner - Family PracticePractitioner - Pediatric Medicine 4688565765 Reassigns benefits to 1 organization
Practice locations: La Canada, CA

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Janesri de Silva M.D. a Prof Corp CurrentSince Mar 20, 2020 Accepting new patients
Healthcare Partners Affiliates Medical Group Family Medicine Past Accepting new patients
Usc Verdugo Hills Hospital Past Accepting new patients

Locations

1442 Foothill Blvd
La Canada Flintridge, CA 91011
Phone (747) 233-3295

504 S Sierra Madre Blvd
Pasadena, CA 91107
Phone (626) 795-8811

Organizations & group practices 3

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": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474502400000",
    "number": "1386618270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 VERDUGO BLVD",
            "address_2": "SUITE 407",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912081403",
            "telephone_number": "818-952-7251",
            "fax_number": "818-952-7256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 VERDUGO BLVD",
            "address_2": "SUITE 407",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912081403",
            "telephone_number": "818-952-7251",
            "fax_number": "818-952-7256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZDARZYL",
        "first_name": "MAREK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2016-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A48707",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A48707",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.