Individual provider Active NPI

Noah Isaac Stashower-Marcus, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1710559588
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95032614 Issued in CA
Practice address
5060 Shoreham PL Ste 230&330
San Diego, CA 92122-5903
Phone
(858) 999-1897
NPI assigned
Jul 12, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95032614 CA Primary

Addresses

Primary practice location

5060 Shoreham PL Ste 230&330
San Diego, CA 92122-5903

Mailing address

5060 Shoreham PL Ste 230&330
San Diego, CA 92122-5903
Phone (858) 999-1897

Other practice location 1

1255 Kendall Rd
San Luis Obispo, CA 93401-8750
Phone (805) 781-3535

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241115002639 CA Practitioner - Nurse Practitioner 1355875139 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sokyahealth Medical Group PCGroup PAC ID 8628463015, 180 clinicians

Practice addresses (Care Compare)

5060 Shoreham PL
Suite 330
San Diego, CA 92122-5976
Phone (858) 427-5060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95032614CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sokyahealth Medical Group PC Mental Health CurrentSince Nov 1, 2024 Accepting new patients

Locations

2386 Faraday Ave
Ste 110
Carlsbad, CA 92008
Phone (858) 427-5060

5060 Shoreham Pl
Ste 330
San Diego, CA 92122
Phone (619) 866-0998

Interoperability endpoints

  • Direct secure messaging: noah.stashowermarcus.p1@direct.sokya.nextgenshare.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1626048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1710559588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5060 SHOREHAM PL STE 230&330",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921225903",
            "telephone_number": "858-999-1897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5060 SHOREHAM PL STE 230&330",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921225903",
            "telephone_number": "858-999-1897"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1255 Kendall Rd",
            "address_purpose": "LOCATION",
            "city": "San Luis Obispo",
            "state": "CA",
            "postal_code": "934018750",
            "country_code": "US",
            "telephone_number": "805-781-3535",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STASHOWER-MARCUS",
        "first_name": "NOAH",
        "middle_name": "ISAAC",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-12",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95032614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.