Individual provider Active NPI

Arlyn Marrero-Nasirov, MD

  • Pediatrics Physician
  • Sacramento, CA
National Provider Identifier
1518167667
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A89538 Issued in CA
Practice address
2425 Alhambra Blvd
Sacramento, CA 95817-1955
Phone
(916) 737-5555
NPI assigned
Jul 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X A89538 CA
Pediatrics Physician 208000000X A89538 CA Primary

Addresses

Primary practice location

2425 Alhambra Blvd
Sacramento, CA 95817-1955

Mailing address

393 E Walnut St
3Rd Floor - PHR Systems
Pasadena, CA 91188-0001
Phone (626) 405-7914

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131227001141 CA Practitioner - Pediatric Medicine 5294716213 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A89538CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspace Health CurrentSince Jul 31, 2023 Accepting new patients
Wellspace Health Current Accepting new patients
Wellspace Health Professional Health Center for Women CurrentSince Jul 31, 2023 Accepting new patients

Locations

1820 J St
Sacramento, CA 95811
Phone (916) 550-5481

777 12th St
Ste 250
Sacramento, CA 95814
Phone (916) 469-4690

2425 Alhambra Blvd
Sacramento, CA 95817
Phone (916) 313-8400

Interoperability endpoints

  • Direct secure messaging: marrero-nasirov.arlyn.001.0050228@wpma.meditab.direct-ci.com
  • Direct secure messaging: amarreronasirov769550@direct.ochin.org
  • Direct secure messaging: marrero-nasirov.arlyn.002.0050228@wpma.meditab.direct-ci.com
  • Direct secure messaging: arlyn.marreronasirov.p1@direct.wellspacehealth.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": "1184716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1518167667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "393 E WALNUT ST",
            "address_2": "3RD FLOOR - PHR SYSTEMS",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911880001",
            "telephone_number": "626-405-7914",
            "fax_number": "626-405-6768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 ALHAMBRA BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171955",
            "telephone_number": "916-737-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARRERO-NASIROV",
        "first_name": "ARLYN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-18",
        "last_updated": "2023-08-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "CA",
            "license": "A89538",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A89538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.