Individual provider Active NPI

S Joseph Marianayagam, MD

  • Internal Medicine Physician
  • Lancaster, CA
National Provider Identifier
1679673776
Registry record updated Aug 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A43915 Issued in CA
Practice address
1331 West Avenue J
Suite 203
Lancaster, CA 93534
Phone
(661) 948-0012
Fax
(661) 940-0206
NPI assigned
Sep 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A43915 CA Primary

Addresses

Primary practice location

1331 West Avenue J
Suite 203
Lancaster, CA 93534

Mailing address

1331 West Avenue J
Suite 203
Lancaster, CA 93534
Phone (661) 948-0012

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
I20101110000511 CA Practitioner - Internal Medicine 2769677277 Practice locations: Lancaster, CA

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1968
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1331 W Ave J
Suite 203
Lancaster, CA 93534-2942
Phone (661) 948-0012

Hospital & facility affiliations

  • Blue Sky Home Health Care, Inc Home health agency, Van Nuys, CA, CCN 059126
  • Antelope Valley Hospital Hospital, Lancaster, CA, CCN 050056

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43915CAMDGeneral Practice Dentistry
A43915CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Antelope Valley Health Care District Past Accepting new patients

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.

Hospital & facility affiliations 2

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": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281052800000",
    "number": "1679673776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 WEST AVENUE J",
            "address_2": "SUITE 203",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "93534",
            "telephone_number": "661-948-0012",
            "fax_number": "661-940-0206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 WEST AVENUE J",
            "address_2": "SUITE 203",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "93534",
            "telephone_number": "661-948-0012",
            "fax_number": "661-940-0206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARIANAYAGAM",
        "first_name": "S JOSEPH",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2010-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A43915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

Verify at the official NPI Registry.