Active NPI
Rosalie S Maduro
- Marriage & Family Therapist
- Venice, CA
National Provider Identifier
1912601238
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 136948
- Practice address
- 1748 Washington Way
Venice, CA 90291-4702 - Phone
- (202) 841-4645
- NPI assigned
- Mar 29, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 136948 | CA | Primary |
Addresses
Primary practice location
1748 Washington Way
Venice, CA 90291-4702
Mailing address
1501 Lincoln Blvd
Venice, CA 90291-3503
Phone (215) 584-2973
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective May 6, 2026 through May 6, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 136948 | CA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1680048000000",
"number": "1912601238",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1501 LINCOLN BLVD",
"city": "VENICE",
"state": "CA",
"postal_code": "902913503",
"telephone_number": "215-584-2973"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1748 WASHINGTON WAY",
"city": "VENICE",
"state": "CA",
"postal_code": "902914702",
"telephone_number": "202-841-4645"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MADURO",
"first_name": "ROSALIE",
"middle_name": "S",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-29",
"last_updated": "2023-03-29",
"certification_date": "2023-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "136948",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Venice, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2023; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.