Individual provider Active NPI

T J Maroon II, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Roseville, CA
National Provider Identifier
1720056153
Registry record updated Apr 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
A55307 Issued in CA
Practice address
729 Sunrise Ave Ste 602
Roseville, CA 95661-4542
Phone
(916) 953-7571
Fax
(916) 771-8515
NPI assigned
Mar 10, 2006
Last updated
Apr 9, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A55307 CA
Pain Medicine (Anesthesiology) Physician 207LP2900X A55307 CA Primary

Addresses

Primary practice location

729 Sunrise Ave Ste 602
Roseville, CA 95661-4542

Mailing address

5098 Foothills Blvd # 3-335
Roseville, CA 95747-6526
Phone (916) 765-8698

Other practice location 1

480 Del Norte Ave
Yuba City, CA 95991-4125
Phone (916) 953-7571

Other identifiers 1

IdentifierTypeStateIssuer
GR0046250MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A55307CAMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Pain Diagnostic & Solutions, Inc. CurrentSince Jun 28, 2020 Accepting new patients
Sierra Nevada Anesthesia Medical Assoc Inc Anesthesiology Past Accepting new patients
Sierra Nevada Anesthesia Medical Associates, Inc. Anesthesiology Past Accepting new patients
Anesthesia Consultants of Sacramento a Medical Group, Inc. Anesthesiology Past Accepting new patients

Locations

729 Sunrise Ave
Ste 602
Roseville, CA 95661
Phone (916) 781-7882

729 Sunrise Ave
Ste 611
Roseville, CA 95661
Phone (916) 953-7571

480 Del Norte Ave
Yuba City, CA 95991
Phone (916) 953-7571

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: tj.maroon.p1@direct.apdss.nextgenshare.com

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, 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": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586390400000",
    "number": "1720056153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5098 FOOTHILLS BLVD # 3-335",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "957476526",
            "telephone_number": "916-765-8698",
            "fax_number": "916-783-6695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "729 SUNRISE AVE STE 602",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614542",
            "telephone_number": "916-953-7571",
            "fax_number": "916-771-8515"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "480 Del Norte Ave",
            "address_purpose": "LOCATION",
            "city": "Yuba City",
            "state": "CA",
            "postal_code": "959914125",
            "country_code": "US",
            "telephone_number": "916-953-7571",
            "fax_number": "916-771-8515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAROON",
        "first_name": "T",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2020-04-09",
        "certification_date": "2020-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A55307",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "A55307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0046250",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.