Miriam Mackovic-Basic

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

A52699 Issued in CA

Practice address

3650 South St Ste 403
Lakewood, CA 90712-1504

Phone

(562) 634-8812

Fax

(562) 634-6033

NPI assigned

Jul 15, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Complete Care Surgical Center LLC

  • Ambulatory Surgical Clinic/Center
  • Long Beach, CA
  • NPI 1639419104
  NPD Authorized official
• Complete Women Care, Inc.

  • Obstetrics & Gynecology Physician
  • Rolling Hills Estates, CA
  • NPI 1144782491
  NPD (past)
• Complete Women Care, Inc.

  • Obstetrics & Gynecology Physician
  • Long Beach, CA
  • NPI 1659792760
  NPD (past)

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548286016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 SOUTH ST STE 403",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907121504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 SOUTH ST STE 403",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907121504",
            "telephone_number": "562-634-8812",
            "fax_number": "562-634-6033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKOVIC-BASIC",
        "first_name": "MIRIAM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A52699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luxottica Retail North America Inc
• Emily Ly
• Amy Lyon, MS, RD
• Annie Ma
• Joseph Benhur Manuel Macapagal
• Tonisha Cassandra Madison
• Esmeralda Madrid
• William L Madrid, M.D.
• Mafutaga S. Tagaloa-Tulifau
• Frank Billy Magana III, PTA

• Obstetrics & Gynecology Physician in Lakewood, CA
• Providers in Lakewood, CA by specialty
• Obstetrics & Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.