Individual provider Active NPI

Marvin J Atchison, MD

  • Surgery Physician
  • Wildomar, CA
National Provider Identifier
1730141383
Registry record updated Dec 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
50639 Issued in AZ
Practice address
36320 Inland Valley Dr.
Suite 101a
Wildomar, CA 92595-7512
Phone
(480) 354-3200
Fax
(480) 354-0391
NPI assigned
Apr 6, 2006
Last updated
Dec 17, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A70292 CA
Surgery Physician 208600000X 50639 AZ Primary

Addresses

Primary practice location

36320 Inland Valley Dr.
Suite 101a
Wildomar, CA 92595-7512

Mailing address

36320 Inland Valley Dr.
Suite 101a
Wildomar, CA 92595-7512
Phone (480) 354-3200

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
I20040121000518 CA Practitioner - General SurgeryPractitioner - Other (Physician) 9335041417 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Loma Linda University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inland Valley Trauma and Acute Care Surgery Apc IncGroup PAC ID 9830444751, 11 clinicians
Murrieta Valley Surgery Associates Medical Group Inc ApcGroup PAC ID 6002136926, 16 clinicians

Practice addresses (Care Compare)

36320 Inland Valley Dr
Suite 101
Wildomar, CA 92595-7512
Phone (951) 698-3000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50639AZMDSurgery Physician
A70292CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Murrieta Valley Surgery Associates Medical Group, Inc, Apc Surgery CurrentSince Nov 4, 2019 Accepting new patients
Mission Hospital Regional Medical Center Past Accepting new patients
Murrieta Valley Surgery Center, Inc.a Professional Corporation Past Accepting new patients
Banner Baywood Medical Center Past Accepting new patients
Banner Heart Hospital Past Accepting new patients
Universal Health Services of Rancho Springs Inc Past Accepting new patients
Memorial Medical Center Past Accepting new patients
Memorial Hospital Inc Past Accepting new patients
Memorial Medical Center Inc Past Accepting new patients
Temecula Valley Hospital Inc Past Accepting new patients
Memorial Medical Center Past Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
PHC-Las Cruces Inc Past Accepting new patients

Locations

830 Magnolia Ave
Ste 1
Corona, CA 92879

3853 W Stetson Ave
Ste 105
Hemet, CA 92545

31537 Rancho Pueblo Rd
Temecula, CA 92592
Phone (951) 303-2277

31537 Rancho Pueblo Rd
Ste 202
Temecula, CA 92592
Phone (951) 698-3000

36320 Inland Valley Dr
Ste 101
Wildomar, CA 92595
Phone (951) 600-3811

36320 Inland Valley Dr
Ste 101A
Wildomar, CA 92595
Phone (951) 698-3000

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 15

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.

View all 15

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": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576540800000",
    "number": "1730141383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36320 INLAND VALLEY DR.",
            "address_2": "SUITE 101A",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925957512",
            "telephone_number": "480-354-3200",
            "fax_number": "480-354-0391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36320 INLAND VALLEY DR.",
            "address_2": "SUITE 101A",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925957512",
            "telephone_number": "480-354-3200",
            "fax_number": "480-354-0391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATCHISON",
        "first_name": "MARVIN",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A70292",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "50639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wildomar, CA

Sources for this page

Verify at the official NPI Registry.