Individual provider Active NPI

Massimo Morra, MD, PHD, FACMG

  • Clinical Medical Laboratory
  • Menlo Park, CA
National Provider Identifier
1447557251
Registry record updated Apr 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
DRN68 Issued in CA
Practice address
1350 Willow Rd Ste 202
Menlo Park, CA 94025-1544
Phone
(650) 752-1345
Fax
(650) 752-1350
NPI assigned
Feb 15, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X DRN68 CA Primary
Clinical Medical Laboratory 291U00000X DI43339 FL
Clinical Medical Laboratory 291U00000X MORRM7 NY

Addresses

Primary practice location

1350 Willow Rd Ste 202
Menlo Park, CA 94025-1544

Mailing address

1350 Willow Rd Ste 202
Menlo Park, CA 94025-1544
Phone (650) 752-1345

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
DRN68CAMDClinical Medical Laboratory
DI43339FLMDClinical Medical Laboratory
MORRM7NYMDClinical Medical Laboratory

Practice roles

OrganizationSpecialtyStatusNew patients
Personalis, Inc. Clinical Medical Laboratory Past Accepting new patients
Personalis, Inc. Clinical Medical Laboratory Past Accepting new patients

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1297728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397174400000",
    "number": "1447557251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 WILLOW RD STE 202",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940251544",
            "telephone_number": "650-752-1345",
            "fax_number": "650-752-1350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 WILLOW RD STE 202",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940251544",
            "telephone_number": "650-752-1345",
            "fax_number": "650-752-1350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRA",
        "first_name": "MASSIMO",
        "credential": "MD, PHD, FACMG",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-02-15",
        "last_updated": "2014-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "DRN68",
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "FL",
            "license": "DI43339",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NY",
            "license": "MORRM7",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menlo Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.