NPIMap

Individual provider Active NPI

Marja-Liisa Magnuson

  • Sports Medicine (Family Medicine) Physician
  • Monterey, CA
National Provider Identifier
1447791876
Registry record updated May 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
20A18721 Issued in CA
Practice address
2 Upper Ragsdale Dr BLDG a
Monterey, CA 93940-5736
Phone
(831) 333-3040
NPI assigned
Mar 18, 2017
Last updated
May 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 18721 CA
Sports Medicine (Family Medicine) Physician 207QS0010X 20A18721 CA Primary

Addresses

Primary practice location

2 Upper Ragsdale Dr BLDG a
Monterey, CA 93940-5736

Mailing address

100 Wilson Rd Ste 100
Monterey, CA 93940-7885
Phone (831) 649-1000

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
I20230424000569 CA Practitioner - Family Practice 4981978566 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Montage Medical GroupGroup PAC ID 6406901941, 125 clinicians

Practice addresses (Care Compare)

2 Upper Ragsdale Dr
BLDG a
Monterey, CA 93940-5736
Phone (831) 718-9701

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A18721CAMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Mary's Medical Group Inc CurrentSince Feb 20, 2021 Accepting new patients
Saint Marys Medical Group Inc. CurrentSince Feb 20, 2021 Accepting new patients
Montage Medical Group CurrentSince May 1, 2023 Accepting new patients
South Lyon Health Center, Inc. Past Accepting new patients
Sparks Family Hospital Inc Past Accepting new patients
Prime Healthcare Services - Reno LLC Past Accepting new patients
Mt Grant General Hospital Past Accepting new patients

Locations

100 Wilson Rd
Ste 100
Monterey, CA 93940
Phone (831) 242-8301

2 Upper Ragsdale Dr
Bldg A
Monterey, CA 93940
Phone (831) 333-3040

23845 Holman Hwy
Ste 210
Monterey, CA 93940
Phone (831) 620-0296

1801 W Olympic Blvd
#1461
Pasadena, CA 91199

18653 Wedge Pkwy
Ste 110
Reno, NV 89511
Phone (775) 352-7201

411 W 6th St
Reno, NV 89503
Phone (775) 770-3209

6255 Sharlands Ave
Reno, NV 89523
Phone (775) 245-6117

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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

Hospital & facility affiliations 4

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": "1489795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715904000000",
    "number": "1447791876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WILSON RD STE 100",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939407885",
            "telephone_number": "831-649-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 UPPER RAGSDALE DR BLDG A",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939405736",
            "telephone_number": "831-333-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGNUSON",
        "first_name": "MARJA-LIISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-18",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "18721",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "CA",
            "license": "20A18721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey, CA

Sources for this page

Verify at the official NPI Registry.