Individual provider Active NPI

Marina Chechelnitsky, M.D.

  • Ophthalmology Physician
  • San Jose, CA
National Provider Identifier
1629188875
Registry record updated Nov 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A52397 Issued in CA
Practice address
227 N Jackson Ave
San Jose, CA 95116-1603
Phone
(408) 871-5254
Fax
(408) 871-5221
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X A52397 CA Primary

Addresses

Primary practice location

227 N Jackson Ave
San Jose, CA 95116-1603

Mailing address

227 N Jackson Ave
San Jose, CA 95116-1603
Phone (408) 871-5254

Other identifiers 1

IdentifierTypeStateIssuer
00A523970MedicaidCA

Medicare participation

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

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
85.48 of 100Reported as group
Quality
80.12
Promoting interoperability
100
Improvement activities
40
Cost
71.46

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A52397CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
El Camino Health Medical Group Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mchechelnitsky49730@icare.elcaminohospital.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605052800000",
    "number": "1629188875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 N JACKSON AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951161603",
            "telephone_number": "408-871-5254",
            "fax_number": "408-871-5221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 N JACKSON AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951161603",
            "telephone_number": "408-871-5254",
            "fax_number": "408-871-5221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHECHELNITSKY",
        "first_name": "MARINA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-11-11",
        "certification_date": "2020-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A52397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A523970",
            "state": "CA"
        }
    ],
    "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 Nov 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.

Verify at the official NPI Registry.