Individual provider Active NPI

Marcia Eckelman Sablan, MD

  • Family Medicine Physician
  • Mendota, CA
National Provider Identifier
1649266990
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G45421 Issued in CA
Practice address
121 Belmont Ave Ste 100
Mendota, CA 93640-8231
Phone
(559) 424-0610
Fax
(559) 424-0611
NPI assigned
Sep 22, 2005
Last updated
Dec 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G45421 CA Primary

Addresses

Primary practice location

121 Belmont Ave Ste 100
Mendota, CA 93640-8231

Mailing address

121 Belmont Ave Ste 100
Mendota, CA 93640-8231
Phone (559) 424-0610

Other identifiers 1

IdentifierTypeStateIssuer
G45421OtherCACALIFORNIA LICENSE

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
I20111121000835 CA Practitioner - Family Practice 1153519244

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G45421CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arya Medical Group Corp Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: marcia.sablan.1@25900.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1649266990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 BELMONT AVE STE 100",
            "city": "MENDOTA",
            "state": "CA",
            "postal_code": "936408231",
            "telephone_number": "559-424-0610",
            "fax_number": "559-424-0611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 BELMONT AVE STE 100",
            "city": "MENDOTA",
            "state": "CA",
            "postal_code": "936408231",
            "telephone_number": "559-424-0610",
            "fax_number": "559-424-0611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SABLAN",
        "first_name": "MARCIA",
        "middle_name": "ECKELMAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-22",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G45421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA LICENSE",
            "identifier": "G45421",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mendota, CA

Sources for this page

Verify at the official NPI Registry.