Jacob Calvin Marcelo

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

3550 E Philadelphia St
Ontario, CA 91761-2962

Phone

(909) 773-0022

NPI assigned

Aug 14, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Izuchukwu Okpara MD IncGroup PAC ID 1052698966, 45 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jacob.marcelo.1@7542.direct.athenahealth.com

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.

• Izuchukwu Okpara MD Inc

  • Surgery Physician
  • Valencia, CA
  • NPI 1679004592
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1755129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755129600000",
    "number": "1770469629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3550 E PHILADELPHIA ST",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917612962",
            "telephone_number": "909-773-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 E PHILADELPHIA ST",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917612962",
            "telephone_number": "909-773-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCELO",
        "first_name": "JACOB CALVIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-14",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Mar, DMD
• Benedict Marasigan
• Carolina Maravilla
• Colleen Elizabeth Maravilla, RPT
• Samantha Maravillo
• Imelda Mares, MASTERS IN SCIENCE
• Maria a. Cruz-Agustin D.D.S Inc
• Maria Vargas Licensed Clinical Social Worker
• Maria Z. Carbajal, DDS, Inc
• Alejandro Marin

• Physician Assistant in Ontario, CA
• Providers in Ontario, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2025; 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.