Individual provider Active NPI

Marlene A Sturm, MD

  • Pediatrics Physician
  • San Jose, CA
National Provider Identifier
1396811360
Registry record updated Sep 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
G71121 Issued in CA
Practice address
1993 McKee Rd
Evc Pediatrics Clinic
San Jose, CA 95116-1406
Phone
(408) 254-6320
NPI assigned
Nov 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X G71121 CA Primary

Addresses

Primary practice location

1993 McKee Rd
Evc Pediatrics Clinic
San Jose, CA 95116-1406

Mailing address

751 S Bascom Ave
San Jose, CA 95128-2604

Other identifiers 1

IdentifierTypeStateIssuer
00G711210MedicaidCA

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
I20090213000058 CA Practitioner - Pediatric Medicine 5991860637 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G71121CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Clara CurrentSince Sep 1, 2019 Accepting new patients
County of Santa Clara CurrentSince Sep 1, 2019 Accepting new patients
County of Santa Clara CurrentSince Sep 1, 2019 Accepting new patients
County of Santa Clara Current Accepting new patients
County of Santa Clara Current Accepting new patients
County of Santa Clara CurrentSince Sep 1, 2019 Accepting new patients
County of Santa Clara Pediatrics Current Accepting new patients

Locations

7475 Camino Arroyo
Gilroy, CA 95020
Phone (408) 852-2400

1993 McKee Rd
San Jose, CA 95116
Phone (408) 254-6320

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

777 E Santa Clara St
San Jose, CA 95112
Phone (408) 885-7200

2101 Alexian Dr
San Jose, CA 95116
Phone (408) 272-6050

750 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-2320

500 Tully Rd
San Jose, CA 95111
Phone (408) 817-1433

777 E Santa Clara St
Fl 2
San Jose, CA 95112

1996 Lundy Ave
San Jose, CA 95131
Phone (408) 299-5846

660 S Fair Oaks Ave
Sunnyvale, CA 94086
Phone (408) 885-7366

Organizations & group practices 7

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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189555200000",
    "number": "1396811360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 S BASCOM AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1993 MCKEE RD",
            "address_2": "EVC PEDIATRICS CLINIC",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951161406",
            "telephone_number": "408-254-6320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STURM",
        "first_name": "MARLENE",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2007-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G71121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G711210",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.