Pacific Nephrology Medical Group

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

PACIFIC NEPHROLOGY MEDICAL GROUP

Practice address

323 N Prairie Ave # 334
Inglewood, CA 90301-4502

Phone

(310) 674-8600

Fax

(310) 671-9883

NPI assigned

Jul 30, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Michael Dylan Healy, M.D.NPI 1861495020

Title

Partner

Phone

(310) 674-8600

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Dylan Healy, M.D.

  • Nephrology Physician
  • Inglewood, CA
  • NPI 1861495020
  Medicare reassignment Care Compare group Authorized official
• Stella Marie Feld, M.D.

  • Nephrology Physician
  • Inglewood, CA
  • NPI 1144223397
  Medicare reassignment Care Compare group
• Christopher Woehrstein, M.D.

  • Nephrology Physician
  • Inglewood, CA
  • NPI 1053545129
  Medicare reassignment Care Compare group
• Patrice Ann Marcarelli, MD

  • Infectious Disease Physician
  • Long Beach, CA
  • NPI 1760455000
  NPD (past)

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253491200000",
    "number": "1922013515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 N PRAIRIE AVE # 334",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903014502",
            "telephone_number": "310-674-8600",
            "fax_number": "310-671-9883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 N PRAIRIE AVE # 334",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903014502",
            "telephone_number": "310-674-8600",
            "fax_number": "310-671-9883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC NEPHROLOGY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2009-09-21",
        "status": "A",
        "authorized_official_last_name": "HEALY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "DYLAN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "310-674-8600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0000360",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Ozegbe, PHARMD
• Mario Antonio Pacada, DPM
• Pace Medical Services Inc.
• Joaquin Donaldo Pacheco Uitz
• Karlene Tadipa Pacheco, RN, BSN
• Pacific Pathology Medical Group Inc
• Pacific Respiratory Services
• Jay Lomibao Padillo, PHYSICAL THERAPIST
• Pai and Chan Pharmacy Corp
• Pai and Chan Pharmacy Corp

• Nephrology Physician in Inglewood, CA
• Providers in Inglewood, CA by specialty
• Nephrology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.