Individual provider Active NPI

Marysa Kavalec, LAC

  • Acupuncturist
  • Santa Monica, CA
National Provider Identifier
1609475078
Registry record updated Oct 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
18853 Issued in CA
Practice address
2302 Oak St Apt 3
Santa Monica, CA 90405-5130
Phone
(216) 469-3286
NPI assigned
Oct 18, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 18853 CA Primary

Addresses

Primary practice location

2302 Oak St Apt 3
Santa Monica, CA 90405-5130

Mailing address

2302 Oak St Apt 3
Santa Monica, CA 90405-5130
Phone (216) 469-3286

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Acudote@acudote.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
18853CAMDClinical Psychologist

Interoperability endpoints

  • Direct secure messaging: acudote@acudote.com

NPI Registry JSON

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

{
    "created_epoch": "1602979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602979200000",
    "number": "1609475078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2302 OAK ST APT 3",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904055130",
            "telephone_number": "216-469-3286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2302 OAK ST APT 3",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904055130",
            "telephone_number": "216-469-3286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAVALEC",
        "first_name": "MARYSA",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-18",
        "last_updated": "2020-10-18",
        "certification_date": "2020-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "18853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Acudote@acudote.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Home address",
            "address_1": "2302 Oak St Apt 3",
            "city": "Santa Monica",
            "state": "CA",
            "country_code": "US",
            "postal_code": "904055130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.