Individual provider Active NPI

Mariko Fitzgibbons, M.D.

  • Diagnostic Radiology Physician
  • Duarte, CA
National Provider Identifier
1396050365
Registry record updated Dec 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
118061 Issued in CA
Practice address
1500 Duarte Rd
Duarte, CA 91010-3012
Phone
(626) 256-4673
NPI assigned
Aug 13, 2010
Last updated
Dec 11, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2020

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 118061 CA Primary

Addresses

Primary practice location

1500 Duarte Rd
Duarte, CA 91010-3012

Mailing address

1333 S Mayflower Ave FL 2
Monrovia, CA 91016-4066
Phone (626) 775-3514

Other practice location 1

757 Westwood Plz
Los Angeles, CA 90095-8358
Phone (310) 267-9119

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@cityofhope.direct-ci.com CITY OF HOPE MEDICAL FOUNDATION

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
I20150618003100 CA Practitioner - Diagnostic Radiology 1951612886 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Northwestern University Feinberg Medical School, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
City of Hope Medical FoundationGroup PAC ID 3779751656, 964 clinicians

Practice addresses (Care Compare)

1000 Fivepoint
Irvine, CA 92618-2377
Phone (949) 671-4673

1500 Duarte Rd
Duarte, CA 91010-3012
Phone (626) 256-4673

1500 E Duarte Rd
Duarte, CA 91010-3012

209 Fair Oaks Ave
South Pasadena, CA 91030-1814
Phone (626) 396-2900

320 W 6TH St
Corona, CA 92882-3349
Phone (951) 898-2828

6939 Palm CT
Riverside, CA 92506-2815
Phone (951) 683-6771

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.8 of 100Reported as group
Quality
78.51
Promoting interoperability
100
Improvement activities
40
Cost
70.37

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
118061CAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
City of Hope Medical Foundation CurrentSince Aug 5, 2016 Accepting new patients

Locations

1500 Duarte Rd
Duarte, CA 91010
Phone (626) 359-8111

6939 Palm Ct
Riverside, CA 92506
Phone (760) 416-4832

209 Fair Oaks Ave
South Pasadena, CA 91030
Phone (626) 359-8111

Interoperability endpoints

  • Direct secure messaging: direct@cityofhope.direct-ci.com
  • Direct secure messaging: mfitzgibbons8933@cityofhope.direct-ci.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1281657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1396050365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 S MAYFLOWER AVE FL 2",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910164066",
            "telephone_number": "626-775-3514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 DUARTE RD",
            "city": "DUARTE",
            "state": "CA",
            "postal_code": "910103012",
            "telephone_number": "626-256-4673"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "757 Westwood Plz",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900958358",
            "country_code": "US",
            "telephone_number": "310-267-9119",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FITZGIBBONS",
        "first_name": "MARIKO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-13",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "118061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@cityofhope.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "CITY OF HOPE MEDICAL FOUNDATION",
            "address_1": "1500 Duarte Rd",
            "city": "Duarte",
            "state": "CA",
            "country_code": "US",
            "postal_code": "910103012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Duarte, CA

Sources for this page

Verify at the official NPI Registry.