Individual provider Active NPI

Marissa Rose Silverman, MSPH

  • Family Medicine Physician
  • Santa Monica, CA
National Provider Identifier
1629656004
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A194113 Issued in CA
Practice address
2701 Ocean Park Blvd Ste 118
Santa Monica, CA 90405-5219
Phone
(310) 829-8917
NPI assigned
Mar 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X A194113 CA Primary

Addresses

Primary practice location

2701 Ocean Park Blvd Ste 118
Santa Monica, CA 90405-5219

Mailing address

1114 Ortega St Apt 3
San Francisco, CA 94122-4560
Phone (310) 804-2465

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
I20240822002609 CA Practitioner - Family Practice 8123567195 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, San Francisco School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Saint Johns Medical FoundationGroup PAC ID 0840548624, 282 clinicians

Practice addresses (Care Compare)

2701 Ocean Park Blvd
Suite 118
Santa Monica, CA 90405-5219
Phone (310) 829-8917

Hospital & facility affiliations

  • Saint John'S Health Center Hospital, Santa Monica, CA, CCN 050290

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Saint Johns Medical Foundation Family Medicine CurrentSince Sep 1, 2024 Accepting new patients
Saint John'S Health Clinic Past Accepting new patients

Locations

2336 Santa Monica Blvd
Ste 204
Santa Monica, CA 90404
Phone (310) 453-4477

2701 Ocean Park Blvd
Ste 118
Santa Monica, CA 90405
Phone (310) 399-1885

2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024

901 Wilshire Blvd
Fl 1
Santa Monica, CA 90401
Phone (310) 829-8441

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1629656004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1114 ORTEGA ST APT 3",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941224560",
            "telephone_number": "310-804-2465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 OCEAN PARK BLVD STE 118",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904055219",
            "telephone_number": "310-829-8917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SILVERMAN",
        "first_name": "MARISSA",
        "middle_name": "ROSE",
        "credential": "MSPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-29",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A194113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.