Mary Alice J Ackerman, NP-C

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

209013829 Issued in IL

Practice address

8536 Wilshire Blvd Ste 200
Beverly Hills, CA 90211-3154

Phone

(310) 248-8300

NPI assigned

Feb 17, 2016

Last updated

May 29, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA, OH, KY3 enrollments

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 3

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: maryalice.ackerman@direct.usc.edu

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Usc Care Medical Group, Inc

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1902846306
  Medicare reassignment NPD
• Mercy Health Physicians Youngstown Specialty Care LLC

  • Surgery Physician
  • Youngstown, OH
  • NPI 1649892225
  Medicare reassignment NPD
• Mercy Health Physicians Kentucky Specialty Care LLC

  • Surgery Physician
  • Paducah, KY
  • NPI 1700408093
  Medicare reassignment
• Usc Care Medical Group, Inc

  dba Fair Oaks Clinic

  • Durable Medical Equipment & Medical Supplies
  • Pasadena, CA
  • NPI 1427937390
  NPD
• Mercy Health Physicians Youngstown Specialty Care LLC

  • Durable Medical Equipment & Medical Supplies
  • Boardman, OH
  • NPI 1386316107
  NPD

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

{
    "created_epoch": "1455667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780012800000",
    "number": "1861851958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8536 WILSHIRE BLVD STE 200",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902113154",
            "telephone_number": "310-248-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8536 WILSHIRE BLVD STE 200",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902113154",
            "telephone_number": "310-248-8300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1532 Lone Oak Rd Ste 415",
            "address_purpose": "LOCATION",
            "city": "Paducah",
            "state": "KY",
            "postal_code": "420037943",
            "country_code": "US",
            "telephone_number": "270-442-0103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ACKERMAN",
        "first_name": "MARY ALICE",
        "middle_name": "J",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-17",
        "last_updated": "2026-05-29",
        "certification_date": "2026-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "NP95011936",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IL",
            "license": "209013829",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "KY",
            "license": "4047687",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "maryalice.ackerman@direct.usc.edu",
            "affiliation": "Y",
            "affiliationName": "USC CARE MEDICAL GROUP, INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1520 San Pablo St Ste 4300",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900335330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tanya Abughazaleh, PSY.D
• Access Medical Imaging Inc
• Achillefs Ntranos MD P.C. (Achilles Neurology Clinic)
• Richard Paul Achiro, PH.D.
• Mary Ackerly, LCSW
• Jennifer Acogny, PSY.D.
• Activehealthrx, Inc
• Acupuncture & Herbal Science Inc
• Will J. Adair, OTR/L, CHT
• Adam B Brown, DO,Inc

• Acute Care Nurse Practitioner in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Acute Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2026; 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.