Individual provider Active NPI

Marieta Marcial, RN, FNP

  • Family Nurse Practitioner
  • Fresno, CA
National Provider Identifier
1811095037
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP 11638 Issued in CA
Practice address
3115 N Millbrook Ave
Fresno, CA 93703-1425
Phone
(559) 600-2382
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11638 CA
Family Nurse Practitioner 363LF0000X NP 11638 CA Primary

Addresses

Primary practice location

3115 N Millbrook Ave
Fresno, CA 93703-1425

Mailing address

3433 W Shaw Ave Ste 108
Fresno, CA 93711-3229
Phone (559) 558-4051

Other practice location 1

1107 O St
Firebaugh, CA 93622-2224
Phone (559) 659-9000

Other practice location 2

560 E Herndon Ave Ste 201
Fresno, CA 93720-2824
Phone (559) 437-7304

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170811002412 CA Practitioner - Nurse Practitioner 5597036327 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Long Term Care Medical Group, IncGroup PAC ID 9032016068, 37 clinicians
Community Foundation Medical GroupGroup PAC ID 0345406294, 282 clinicians

Practice addresses (Care Compare)

111 Barlow Ave
Clovis, CA 93612
Phone (559) 299-2591

560 E Herndon Ave
Suite 201
Fresno, CA 93720-2907
Phone (559) 437-7311

Merit-based Incentive Payment System (MIPS)

Final score
90.41 of 100Reported as group
Quality
87.02
Promoting interoperability
100
Improvement activities
40
Cost
78.21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
NP 11638CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Foundation Medical Group CurrentSince Apr 1, 2024 Accepting new patients
Community Foundation Medical Group CurrentSince Apr 1, 2024 Accepting new patients
Long Term Care Medical Group, Inc CurrentSince Mar 1, 2023 Accepting new patients
Community Foundation Medical Group Current Accepting new patients
Central Valley Urgent Care Medical Group Inc CurrentSince Jul 13, 2017 Accepting new patients

Locations

685 W Alluvial Ave
Ste 103
Fresno, CA 93711
Phone (559) 274-6444

925 N Cornelia Ave
Fresno, CA 93706
Phone (559) 275-4785

199 W Shields Ave
Fresno, CA 93705
Phone (559) 225-4706

2335 E Kashian Ln
Ste 270
Fresno, CA 93701
Phone (559) 445-1251

560 E Herndon Ave
Ste 201
Fresno, CA 93720
Phone (559) 437-7311

Interoperability endpoints

  • Direct secure messaging: marieta.marcial.1@11784.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/11784/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1811095037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3433 W SHAW AVE STE 108",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937113229",
            "telephone_number": "559-558-4051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3115 N MILLBROOK AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937031425",
            "telephone_number": "559-600-2382"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1107 O St",
            "address_purpose": "LOCATION",
            "city": "Firebaugh",
            "state": "CA",
            "postal_code": "936222224",
            "country_code": "US",
            "telephone_number": "559-659-9000",
            "fax_number": "559-659-9017",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "560 E Herndon Ave Ste 201",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937202824",
            "country_code": "US",
            "telephone_number": "559-437-7304",
            "fax_number": "559-437-7308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARCIAL",
        "first_name": "MARIETA",
        "name_prefix": "Mrs.",
        "credential": "RN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "11638",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP 11638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.