Individual provider Active NPI

Manar Margergis Michael, P.A.

  • Physician Assistant
  • North Hollywood, CA
National Provider Identifier
1407800188
Registry record updated Feb 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA17555 Issued in CA
Practice address
12157 Victory Blvd
North Hollywood, CA 91606-3204
Phone
(818) 755-8000
Fax
(818) 755-8006
NPI assigned
May 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA17555 CA Primary

Addresses

Primary practice location

12157 Victory Blvd
North Hollywood, CA 91606-3204

Mailing address

801 S Chevy Chase Dr
#20
Glendale, CA 91205-4431
Phone (818) 265-2237

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050210000573 CA Practitioner - Physician Assistant 2365493459 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Comprehensive Community Health Centers IncGroup PAC ID 9638082456, 47 clinicians

Practice addresses (Care Compare)

12157 Victory Blvd
N Hollywood, CA 91606-3204
Phone (818) 755-8000

1704 Colorado Blvd
Los Angeles, CA 90041-1338
Phone (323) 256-4116

8316 Foothill Blvd
Sunland, CA 91040-2850
Phone (818) 273-8800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA17555CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Community Health Centers, Inc CurrentSince Apr 20, 2016 Accepting new patients

Locations

801 S Chevy Chase Dr
Ste 250
Glendale, CA 91205
Phone (818) 265-2259

801 S Chevy Chase Dr
Ste 20
Glendale, CA 91205
Phone (818) 265-2210

5059 York Blvd
Los Angeles, CA 90042
Phone (323) 344-4144

12157 Victory Blvd
North Hollywood, CA 91606
Phone (818) 755-8000

Interoperability endpoints

  • Direct secure messaging: manarmichael@cchc.trimed.direct-ci.com

Organizations & group practices 2

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": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266883200000",
    "number": "1407800188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 S CHEVY CHASE DR",
            "address_2": "#20",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912054431",
            "telephone_number": "818-265-2237",
            "fax_number": "818-265-2228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12157 VICTORY BLVD",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916063204",
            "telephone_number": "818-755-8000",
            "fax_number": "818-755-8006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHAEL",
        "first_name": "MANAR",
        "middle_name": "MARGERGIS",
        "name_prefix": "Mrs.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2010-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA17555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Hollywood, CA

Sources for this page

Verify at the official NPI Registry.