Active NPI
Marina Marie Mulvey, AUD
- Audiologist
- Santa Rosa, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- AU1683
- Practice address
- 4725 Hoen Avenue
Suite B
Santa Rosa, CA 95405-9405 - Phone
- (707) 542-1154
- Fax
- (707) 542-4818
- NPI assigned
- Feb 14, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | AU1683 | CA | Primary |
| Hearing Instrument Specialist | 237700000X | HA3313 | CA |
Addresses
Primary practice location
4725 Hoen Avenue
Suite B
Santa Rosa, CA 95405-9405
Mailing address
4725 Hoen Avenue
Suite B
Santa Rosa, CA 95405-9405
Phone (707) 542-1154
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AU0016830 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Audiologist
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2169 S Ave
South Lake Tahoe, CA 96150-7059
Phone (530) 543-5400
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.71 of 100
- Quality
- 89.85
- Promoting interoperability
- 94.05
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AU1683 | CA | MD | Audiologist |
| HA3313 | CA | MD | Hearing Instrument Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tahoe Carson Valley Medical Group Inc | Current | Accepting new patients | |
| Barton Medical Foundation | Current | Accepting new patients | |
| Connect Hearing, Inc. | Audiologist | Past | Accepting new patients |
| Connect Hearing, Inc. | Audiologist | Past | Accepting new patients |
| Connect Hearing, Inc. | Audiologist | Past | Accepting new patients |
| Connect Hearing, Inc. | Audiologist | Past | Accepting new patients |
| Connect Hearing, Inc. | Audiologist | Past | Accepting new patients |
| Connect Hearing, Inc. | Audiologist | Past | Accepting new patients |
Locations
2169 South Ave
South Lake Tahoe, CA 96150
Phone (530) 543-5400
2074 Lake Tahoe Blvd
Ste 4
South Lake Tahoe, CA 96150
Phone (530) 543-5554
2170 South Ave
South Lake Tahoe, CA 96150
Phone (530) 541-3420
1090 3rd St
South Lake Tahoe, CA 96150
Phone (530) 543-5660
Organizations & group practices 8
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.
-
- Family Medicine Physician
- South Lake Tahoe, CA
- NPI 1750950499
-
- Family Medicine Physician
- South Lake Tahoe, CA
- NPI 1508865528
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1461628800000",
"number": "1497898043",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4725 HOEN AVENUE",
"address_2": "SUITE B",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954059405",
"telephone_number": "707-542-1154",
"fax_number": "707-542-4818"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4725 HOEN AVENUE",
"address_2": "SUITE B",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954059405",
"telephone_number": "707-542-1154",
"fax_number": "707-542-4818"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULVEY",
"first_name": "MARINA",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "AUD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-14",
"last_updated": "2016-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "CA",
"license": "AU1683",
"primary": true
},
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": "CA",
"license": "HA3313",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "AU0016830",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Santa Rosa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.