Individual provider Active NPI

Marc K Eckstein, M.D.

  • Emergency Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1922010867
Registry record updated Dec 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
G69852 Issued in CA
Practice address
1200 N State St
Suite 1011
Los Angeles, CA 90033-1029
Phone
(323) 226-6667
NPI assigned
Aug 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X T4513 TX
Emergency Medicine Physician 207P00000X ME153176 FL
Emergency Medicine Physician 207P00000X G69852 CA Primary

Addresses

Primary practice location

1200 N State St
Suite 1011
Los Angeles, CA 90033-1029

Mailing address

155 N Lake Ave
Ste 800
Pasadena, CA 91101-1857
Phone (254) 835-3911

Other identifiers 1

IdentifierTypeStateIssuer
00G698520MedicaidCA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040914001374 CA Practitioner - Emergency Medicine 3274500640 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Icahn School of Medicine at Mount Sinai, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Team Physicians of California Medical Group IncGroup PAC ID 8224945084, 92 clinicians

Practice addresses (Care Compare)

215 W Janss Rd
Thousand Oaks, CA 91360-1847
Phone (805) 497-2727

Hospital & facility affiliations

  • Los Robles Hospital & Medical Center Hospital, Thousand Oaks, CA, CCN 050549

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
69852CAMDPediatric Pharmacist
G69852CAMDEmergency Medicine Physician
T4513TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Team Physicians of California Medical Group Inc Emergency Medicine CurrentSince Jun 1, 2024 Accepting new patients
West Hills Emergency Medical Associates, Inc Emergency Medicine CurrentSince Jun 1, 2010 Accepting new patients
Los Robles Emergency Physicians Medical Group Emergency Medicine CurrentSince Jul 1, 2023 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Apr 1, 2018 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Apr 1, 2018 Accepting new patients
Usc Verdugo Hills Hospital, LLC Past Accepting new patients
Centinela Freeman Emergency Medical Associates Emergency Medicine Past Accepting new patients
Keck Medical Center of Usc Past Accepting new patients
Usc University Hospital, Inc. Past Accepting new patients

Locations

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

1200 N State St
Ste 1011
Los Angeles, CA 90089
Phone (323) 226-6667

1300 N Vermont Ave
Los Angeles, CA 90027
Phone (213) 413-3000

215 W Janss Rd
Thousand Oaks, CA 91360
Phone (805) 379-5435

7300 Medical Ctr
West Hills, CA 91307
Phone (818) 612-8301

Organizations & group practices 9

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639612800000",
    "number": "1922010867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 N LAKE AVE",
            "address_2": "STE 800",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911011857",
            "telephone_number": "254-835-3911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST",
            "address_2": "SUITE 1011",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331029",
            "telephone_number": "323-226-6667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECKSTEIN",
        "first_name": "MARC",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "T4513",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME153176",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G69852",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G698520",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.