NPIMap

Individual provider Active NPI

Mariola L Ficinski, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Los Angeles, CA
National Provider Identifier
1659371367
Registry record updated Feb 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
A50558 Issued in CA
Practice address
1245 Wilshire Blvd Ste 817
Los Angeles, CA 90017-4808
Phone
(213) 250-5255
Fax
(213) 250-5265
NPI assigned
Jul 22, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X A50558 CA Primary

Addresses

Primary practice location

1245 Wilshire Blvd Ste 817
Los Angeles, CA 90017-4808

Mailing address

1245 Wilshire Blvd Ste 817
Los Angeles, CA 90017-4808
Phone (213) 250-5255

Other identifiers 2

IdentifierTypeStateIssuer
00A505580MedicaidCA
110133236OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040318001206 CA Practitioner - EndocrinologyPractitioner - Internal Medicine 4981594306 Practice locations: Los Angeles, CA

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1245 Wilshire Blvd
Suite 817
Los Angeles, CA 90017-4808
Phone (213) 977-1030

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A50558CAMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Good Samaritan Hospital, L.P. Past Accepting new patients
Barlow Respiratory Hospital Past Accepting new patients
Pih Health Good Samaritan Hospital Past Accepting new patients
Usc Internal Medicine, Inc. Endocrinology, Diabetes & Metabolism Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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 5

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": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1659371367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 WILSHIRE BLVD STE 817",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900174808",
            "telephone_number": "213-250-5255",
            "fax_number": "213-250-5265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 WILSHIRE BLVD STE 817",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900174808",
            "telephone_number": "213-250-5255",
            "fax_number": "213-250-5265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FICINSKI",
        "first_name": "MARIOLA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-22",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "A50558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A505580",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110133236",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.