NPIMap

Individual provider Active NPI

Mylon Marshall, M.D.

  • Vascular & Interventional Radiology Physician
  • Sacramento, CA
National Provider Identifier
1720087059
Registry record updated Feb 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
G67047 Issued in CA
Practice address
2801 K St
Suite 502
Sacramento, CA 95816-5120
Phone
(877) 515-0053
Fax
(916) 454-6926
NPI assigned
Jul 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2014

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging Physician 2085B0100X G67047 CA
Neuroradiology Physician 2085N0700X G67047 CA
Nuclear Radiology Physician 2085N0904X G67047 CA
Diagnostic Radiology Physician 2085R0202X G67047 CA
Therapeutic Radiology Physician 2085R0203X G67047 CA
Vascular & Interventional Radiology Physician 2085R0204X G67047 CA Primary
Radiological Physics Physician 2085R0205X G67047 CA
Diagnostic Ultrasound Physician 2085U0001X G67047 CA

Addresses

Primary practice location

2801 K St
Suite 502
Sacramento, CA 95816-5120

Mailing address

10470 Old Placerville Rd
Suite 100
Sacramento, CA 95827-2539
Phone (800) 470-0071

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G67047CAMDTherapeutic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiological Associates of Sacramento Medical Group Body Imaging Past Accepting new patients
Radiological Associates of Sacramento Medical Group Inc Body Imaging Past Accepting new patients
Radiological Associates of Sacramento Medical Group Inc Body Imaging Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mmarshall37637@hisp.ehr.sutterhealth.org

Organizations & group practices 3

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": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391472000000",
    "number": "1720087059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10470 OLD PLACERVILLE RD",
            "address_2": "SUITE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272539",
            "telephone_number": "800-470-0071",
            "fax_number": "916-731-7877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 K ST",
            "address_2": "SUITE 502",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165120",
            "telephone_number": "877-515-0053",
            "fax_number": "916-454-6926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "MYLON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2014-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "CA",
            "license": "G67047",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "CA",
            "license": "G67047",
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "CA",
            "license": "G67047",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G67047",
            "primary": false
        },
        {
            "code": "2085R0203X",
            "taxonomy_group": "",
            "desc": "Radiology, Therapeutic Radiology",
            "state": "CA",
            "license": "G67047",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CA",
            "license": "G67047",
            "primary": true
        },
        {
            "code": "2085R0205X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiological Physics",
            "state": "CA",
            "license": "G67047",
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "CA",
            "license": "G67047",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.