Vivian M Marcuzzo, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA17936 Issued in CA

Practice address

2730 S Val Vista Dr
Suite 187
Gilbert, AZ 85295-1675

Phone

(480) 324-0300

Fax

(480) 324-0324

NPI assigned

Aug 21, 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 2

Medicare fee-for-service enrollment

Enrolled in AZ

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

Telehealth

Offers telehealth services

Group practices

Kerry S Green MD PLCGroup PAC ID 3476538729, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner Baywood Medical Center Hospital, Mesa, AZ, CCN 030088
• Banner Gateway Medical Center Hospital, Gilbert, AZ, CCN 030122

Merit-based Incentive Payment System (MIPS)

Final score

27.11 of 100Reported as individual

Quality

15

Improvement activities

0

Cost

70.37

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Kerry S Green MD PLC

  • Clinic/Center
  • Mesa, AZ
  • NPI 1356523492
  Medicare reassignment Care Compare group
• Mobile Medical Group

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • San Diego, CA
  • NPI 1942447651
  NPD (past)

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

• Banner Baywood Medical Center

  • General Acute Care Hospital
  • Mesa, AZ
  • NPI 1194758284
  Care Compare affiliation
• Banner Gateway Medical Center

  • General Acute Care Hospital
  • Gilbert, AZ
  • NPI 1699884858
  Care Compare affiliation

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1932215407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6112 E BROWN RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852054955",
            "telephone_number": "480-448-0244",
            "fax_number": "480-924-4140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2730 S VAL VISTA DR",
            "address_2": "SUITE 187",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852951675",
            "telephone_number": "480-324-0300",
            "fax_number": "480-324-0324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCUZZO",
        "first_name": "VIVIAN",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA17936",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA17938",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00281443",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Marie Maratas, BSN, RN
• Marc Community Resources, Inc.
• Marc Community Resources, Inc.
• Milton Marchbanks
• Marco Marsella, M.D. P.C.
• Dayana Mardueno
• Kelly Marek
• David Margraf, PHARMD
• Matthew Marini, M.D.
• Vlada Markov

• Physician Assistant in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.