NPIMap

Organization Active NPI

Willow Brook Critical Care Medical Group, Inc

  • Hospitalist Physician
  • Glendale, CA
National Provider Identifier
1811520224
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
Legal business name
WILLOW BROOK CRITICAL CARE MEDICAL GROUP, INC
Practice address
1420 S Central Ave
Glendale, CA 91204-2508
Phone
(448) 474-4019
Fax
(330) 493-8677
NPI assigned
Feb 14, 2020
Last updated
Feb 12, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

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

Authorized official

Name
Steven Peter Maron, MDNPI 1821026063
Title
MD
Phone
(303) 493-4443

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X NU Primary

Addresses

Primary practice location

1420 S Central Ave
Glendale, CA 91204-2508

Mailing address

4535 Dressler Rd NW
Canton, OH 44718-2545
Phone (844) 474-4019

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200622002378 CA Part B Supplier - Clinic/Group Practice 3476975319 Receives reassigned benefits from 72 practitioners
Practice locations: Glendale, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 74

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 74

NPI Registry JSON

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

{
    "created_epoch": "1581638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739318400000",
    "number": "1811520224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4535 DRESSLER RD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182545",
            "telephone_number": "844-474-4019",
            "fax_number": "781-276-6486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 S CENTRAL AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042508",
            "telephone_number": "448-474-4019",
            "fax_number": "330-493-8677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW BROOK CRITICAL CARE MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-14",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A",
        "authorized_official_last_name": "MARON",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "PETER",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "303-493-4443",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.