Individual provider Active NPI

Marc A Fierro, P.A.

  • Medical Physician Assistant
  • Roseville, CA
National Provider Identifier
1861552556
Registry record updated Feb 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA15185 Issued in CA
Practice address
2 Medical Plaza Dr Ste 205
Roseville, CA 95661-3044
Phone
(916) 773-8711
NPI assigned
Dec 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA15185 CA Primary

Addresses

Primary practice location

2 Medical Plaza Dr Ste 205
Roseville, CA 95661-3044

Mailing address

PO Box 255228
Sacramento, CA 95865-5228

Other practice location 1

11333 Prospect Dr Ste 401
Jackson, CA 95642-9311
Phone (290) 268-0560

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
I20140915001273 CA Practitioner - Physician Assistant 3971722521 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

2800 L St
Sacramento, CA 95816-5616

8 Medical Plaza Dr
Roseville, CA 95661-3106
Phone (916) 782-5106

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA15185CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation CurrentSince Feb 8, 2021 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Feb 8, 2021 Accepting new patients
Wellspace Health CurrentSince Dec 16, 2019 Accepting new patients
Kristine Burke MD, Inc. Current Accepting new patients
Wellspace Health CurrentSince Dec 16, 2019 Accepting new patients
Center for Functional & Integrative Medicine, Inc Past Accepting new patients
Sutter North Medical Foundation Past Accepting new patients

Locations

4901 Golden Foothill Pkwy
Ste C
El Dorado Hls, CA 95762
Phone (530) 676-1003

11333 Prospect Dr
Ste 401
Jackson, CA 95642
Phone (290) 268-0560

11333 Prospect Dr
Jackson, CA 95642
Phone (209) 268-0560

8 Medical Plaza Dr
Ste 300
Roseville, CA 95661
Phone (916) 782-5106

2 Medical Plaza Dr
Ste 205
Roseville, CA 95661
Phone (916) 773-8711

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

777 12th St
Ste 250
Sacramento, CA 95814
Phone (916) 469-4690

Interoperability endpoints

  • Direct secure messaging: mfierro221502@hisp.ehr.sutterhealth.org

Organizations & group practices 8

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": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612137600000",
    "number": "1861552556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 255228",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958655228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 MEDICAL PLAZA DR STE 205",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613044",
            "telephone_number": "916-773-8711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11333 Prospect Dr Ste 401",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "CA",
            "postal_code": "956429311",
            "country_code": "US",
            "telephone_number": "290-268-0560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FIERRO",
        "first_name": "MARC",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA15185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.