Mara Beth Coyne, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PT-18312 Issued in CA

Practice address

1505 Wilson Ter
Suite 200
Glendale, CA 91206-4071

Phone

(818) 246-8974

Fax

(818) 246-7673

NPI assigned

May 26, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Glendale Adventist Medical CenterGroup PAC ID 4284692096, 99 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Glendale Adventist Medical Center Hospital, Glendale, CA, CCN 050239

Merit-based Incentive Payment System (MIPS)

Final score

95.77 of 100Reported as apm

Quality

81.54

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

85.77 of 100Reported as group

Quality

78.77

Promoting interoperability

92

Improvement activities

40

Cost

48

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Glendale Adventist Medical Center

  • General Acute Care Hospital
  • Glendale, CA
  • NPI 1831188275

  CA

  Medicare reassignment Care Compare group NPD
• Adventist Health Physicians Network

  • Family Medicine Physician
  • Glendale, CA
  • NPI 1083976294

  CA

  Medicare reassignment
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280

  CA

  Medicare reassignment
• Glendale Adventist Medical Center

  • Skilled Nursing Facility
  • Glendale, CA
  • NPI 1114916293
  Care Compare group NPD (past)
• Glendale Adventist Medical Center

  • Psychiatric Hospital Unit
  • Glendale, CA
  • NPI 1336138403
  Care Compare group
• Glendale Adventist Medical Center

  • Rehabilitation Hospital Unit
  • Glendale, CA
  • NPI 1396734471
  Care Compare group
• Glendale Adventist Medical Center

  • Community/Retail Pharmacy
  • Glendale, CA
  • NPI 1588040786
  Care Compare group
• Adventist Health Physicians Network

  • Physical Therapy Clinic/Center
  • Paradise, CA
  • NPI 1134092190
  NPD
• Adventist Health Physicians Network

  • Vascular Surgery Physician
  • Glendale, CA
  • NPI 1316327182
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Panorama City, CA
  • NPI 1407888928
  NPD
• Adventist Health Heart Institute-Ukiah

  • Multi-Specialty Clinic/Center
  • Ukiah, CA
  • NPI 1417295643
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Glendale Adventist Medical Center

  • General Acute Care Hospital
  • Glendale, CA
  • NPI 1831188275

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1902852155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27426 CHERRY CREEK DR",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913542056",
            "telephone_number": "661-297-3930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 WILSON TER",
            "address_2": "SUITE 200",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064071",
            "telephone_number": "818-246-8974",
            "fax_number": "818-246-7673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COYNE",
        "first_name": "MARA",
        "middle_name": "BETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PT-18312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANT",
            "identifier": "PT-18312",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "25825 Vermont Ave",
            "city": "Harbor City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "907103518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• County of Los Angeles Auditor Controller
• County of Los Angeles Auditor Controller
• County of Los Angeles Auditor Controller
• Cover RX Inc
• Cover RX Inc
• Coziness Care Home Health Care, Inc.
• Coziness Care Hospice, Inc.
• Cozy Care Hospice Inc
• Cqi Homecare Inc
• Cqi Homecare Inc

• All providers in Glendale, CA
• Surgical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2021; 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.