Active NPI
I. David Marcus, PHD
- Psychologist
- San Jose, CA
National Provider Identifier
1528306164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY16216
- Practice address
- 1022 W Hedding St
San Jose, CA 95126-1245 - Phone
- (408) 313-3365
- Fax
- (408) 248-9753
- NPI assigned
- Jan 16, 2013
- Last updated
- Jan 16, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY16216 | CA | Primary |
Addresses
Primary practice location
1022 W Hedding St
San Jose, CA 95126-1245
Mailing address
1022 W Hedding St
San Jose, CA 95126-1245
Phone (408) 313-3365
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jan 1, 2017 through Jan 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY16216 | CA | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nga Thu Nguyen | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinical Social Worker
- San Jose, CA
- NPI 1588099204
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1358294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1358294400000",
"number": "1528306164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1022 W HEDDING ST",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951261245",
"telephone_number": "408-313-3365",
"fax_number": "408-248-9753"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1022 W HEDDING ST",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951261245",
"telephone_number": "408-313-3365",
"fax_number": "408-248-9753"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARCUS",
"first_name": "I.",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-01-16",
"last_updated": "2013-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY16216",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.