NPIMap

Individual provider Active NPI

Harry Marshak, M.D.

  • Plastic Surgery Physician
  • Beverly Hills, CA
National Provider Identifier
1396751541
Registry record updated Jun 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
G57467 Issued in CA
Practice address
120 S Spalding Dr
#300
Beverly Hills, CA 90212-1800
Phone
(310) 657-7600
NPI assigned
Jul 31, 2006
Last updated
Jun 28, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X G57467 CA Primary
Surgery Physician 208600000X G57467 CA

Addresses

Primary practice location

120 S Spalding Dr
#300
Beverly Hills, CA 90212-1800

Mailing address

PO Box 60790
Pasadena, CA 91116-6790
Phone (626) 795-6596

Other identifiers 1

IdentifierTypeStateIssuer
00G574670MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041229000619 CA Practitioner - Plastic and Reconstructive SurgeryPractitioner - General Surgery 0446218044 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive SurgeryAlso: General Surgery
Education
University of California, Geffen School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

421 N Rodeo Dr
PH 1
Beverly Hills, CA 90210-4531
Phone (310) 657-7600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue59
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G57467CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ahm Medical Corporation Surgery CurrentSince Apr 1, 2013 Accepting new patients
Edgar Z. Cosme, M.D., Inc. Past Accepting new patients

Locations

421 N Rodeo Dr
Beverly Hills, CA 90210
Phone (310) 274-5372

421 N Rodeo Dr
Ph 1
Beverly Hills, CA 90210
Phone (310) 432-6640

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

Hospital & facility affiliations 9

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372377600000",
    "number": "1396751541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60790",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911166790",
            "telephone_number": "626-795-6596",
            "fax_number": "626-795-8247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 S SPALDING DR",
            "address_2": "#300",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902121800",
            "telephone_number": "310-657-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHAK",
        "first_name": "HARRY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2013-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "G57467",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "G57467",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G574670",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

Verify at the official NPI Registry.