Individual provider Active NPI

Tanya Amber Marcus, PAC

  • Physician Assistant
  • El Cajon, CA
National Provider Identifier
1659784130
Registry record updated Apr 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1306 Broadway
El Cajon, CA 92021-5810
Phone
(619) 551-7400
NPI assigned
Jun 3, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1306 Broadway
El Cajon, CA 92021-5810

Mailing address

1306 Broadway
El Cajon, CA 92021-5810
Phone (619) 551-7400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140729002966 NV Practitioner - Physician Assistant 6103042072 Reassigns benefits to 1 organization
I20170731003415 CA Practitioner - Physician Assistant 6103042072 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brian H Weeks MD IncGroup PAC ID 2466635669, 4 clinicians

Practice addresses (Care Compare)

3590 Camino del Rio N
Suite 102
San Diego, CA 92108-1707
Phone (619) 810-1202

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
54501CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors Medical Services, Emcare Past Accepting new patients
Grossmont Hospital Corporation Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: bhw.tanyamarcus@157392.advancedmd-direct.com

Organizations & group practices 5

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": "1401753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651104000000",
    "number": "1659784130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 BROADWAY",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920215810",
            "telephone_number": "619-551-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1306 BROADWAY",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920215810",
            "telephone_number": "619-551-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCUS",
        "first_name": "TANYA",
        "middle_name": "AMBER",
        "credential": "PAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-03",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Cajon, CA

Sources for this page

Verify at the official NPI Registry.