Individual provider Active NPI

Steven Marcus, M.D.

  • Primary Care Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1407098015
Registry record updated Mar 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
G33630 Issued in CA
Practice address
1021 Manning Ave
Los Angeles, CA 90024-3220
Phone
(310) 474-5671
Fax
(310) 474-3985
NPI assigned
Mar 27, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X G33630 CA Primary

Addresses

Primary practice location

1021 Manning Ave
Los Angeles, CA 90024-3220

Mailing address

1021 Manning Ave
Los Angeles, CA 90024-3220
Phone (310) 474-5671

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240606000499 TX Practitioner - Pediatric Medicine 2567788979 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside-San Bernardino County Indian Health, Inc CurrentSince Apr 22, 2024 Accepting new patients
Riverside-San Bernardino County Indian Health, Inc. CurrentSince Apr 22, 2024 Accepting new patients
Riverside-San Bernardino County Indian Health, Inc. Current Accepting new patients

Locations

11980 Mount Vernon Ave
Grand Terrace, CA 92313
Phone (909) 783-8470

Interoperability endpoints

  • Direct secure messaging: steven.marcusmd.p1@direct.jwch.nextgenshare.com

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": "1238112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238112000000",
    "number": "1407098015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 MANNING AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900243220",
            "telephone_number": "310-474-5671",
            "fax_number": "310-474-3985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 MANNING AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900243220",
            "telephone_number": "310-474-5671",
            "fax_number": "310-474-3985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCUS",
        "first_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-27",
        "last_updated": "2009-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "G33630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.