Theodore Cosmo Marentis, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

A131413 Issued in CA

Practice address

6501 Coyle Ave
Nuclear Medicine
Carmichael, CA 95608-0306

Phone

(916) 537-5208

Fax

(916) 537-5425

NPI assigned

Apr 29, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Diagnostic RadiologyAlso: Nuclear Medicine

Education

Harvard Medical School, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy General Hospital Hospital, Sacramento, CA, CCN 050017
• Mercy San Juan Medical Center Hospital, Carmichael, CA, CCN 050516
• Methodist Hospital of Sacramento Hospital, Sacramento, CA, CCN 050590
• Sierra Nevada Memorial Hospital Hospital, Grass Valley, CA, CCN 050150
• Woodland Memorial Hospital Hospital, Woodland, CA, CCN 050127

Merit-based Incentive Payment System (MIPS)

Final score

99.64 of 100Reported as apm

Quality

86.27

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Dignity Health Medical Foundation

  • Multi-Specialty Clinic/Center
  • Sacramento, CA
  • NPI 1700803418
  Medicare reassignment Care Compare group NPD
• Dignity Health Medical Foundation

  • Multi-Specialty Clinic/Center
  • Santa Cruz, CA
  • NPI 1598961245
  NPD
• Dignity Health Medical Foundation

  • Multi-Specialty Clinic/Center
  • Redding, CA
  • NPI 1912288432
  NPD
• Catholic Healthcare West

  • Institutional Pharmacy
  • Red Bluff, CA
  • NPI 1265472914
  NPD (past)
• Dignity Community Care

  • Home Health Agency
  • Woodland, CA
  • NPI 1851494231
  NPD (past)
• Dignity Health

  • General Acute Care Hospital
  • Redding, CA
  • NPI 1477671535
  NPD (past)
• Dignity Health Medical Foundation

  • Multi-Specialty Clinic/Center
  • Rancho Cordova, CA
  • NPI 1568489268
  NPD (past)
• Sequoia Health Services

  • General Acute Care Hospital
  • Redwood City, CA
  • NPI 1235172057
  NPD (past)
• Sierra Nevada Memorial-Miners Hospital

  • General Acute Care Hospital
  • Grass Valley, CA
  • NPI 1659361392
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Dignity Community Care

  • General Acute Care Hospital
  • Sacramento, CA
  • NPI 1467560599
  Care Compare affiliation
• Dignity Community Care

  • General Acute Care Hospital
  • Woodland, CA
  • NPI 1922116037
  Care Compare affiliation
• Dignity Health

  • General Acute Care Hospital
  • Sacramento, CA
  • NPI 1487694857
  Care Compare affiliation
• Dignity Health

  • General Acute Care Hospital
  • Carmichael, CA
  • NPI 1972541498
  Care Compare affiliation
• Sierra Nevada Memorial-Miners Hospital

  • General Acute Care Hospital
  • Grass Valley, CA
  • NPI 1659361392
  Care Compare affiliation

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

{
    "created_epoch": "1240963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411344000000",
    "number": "1740424134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "address_2": "PHYSICIAN SUPPORT SERVICES",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6501 COYLE AVE",
            "address_2": "NUCLEAR MEDICINE",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956080306",
            "telephone_number": "916-537-5208",
            "fax_number": "916-537-5425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARENTIS",
        "first_name": "THEODORE",
        "middle_name": "COSMO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-29",
        "last_updated": "2014-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301093810",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A131413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Guillermo Alberto Mantilla, M.D.
• Araxia Manukyan
• Maria Leigh Manyaga
• Anna Manzyuk, NP
• Michele March
• Maria Ahleen de Leon Medina DMD Corp
• Maria Teresa R de Guzman DDS Corp
• Mark Dylan Kovar DMD, PC
• Lidia Ann Marks-Bratten, CADC-CAS
• Madeline Elizabeth Markstrom, PA

• Diagnostic Radiology Physician in Carmichael, CA
• Providers in Carmichael, CA by specialty
• Diagnostic Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.