Individual provider Active NPI

Kevin Darrow Marcus, M.D.

  • Anesthesiology Physician
  • San Diego, CA
National Provider Identifier
1942509674
Registry record updated Jul 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A123908 Issued in CA
Practice address
4077 Fifth Ave
San Diego, CA 92103-2105
Phone
(619) 260-7220
NPI assigned
Mar 21, 2011
Last updated
Jul 5, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X A123908 CA Primary

Addresses

Primary practice location

4077 Fifth Ave
San Diego, CA 92103-2105

Mailing address

4077 Fifth Ave
San Diego, CA 92103-2105
Phone (619) 260-7220

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
I20160531000929 CA Practitioner - Anesthesiology 4082904263 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Western Anesthesia Medical Associates IncGroup PAC ID 7012902216, 49 clinicians

Practice addresses (Care Compare)

27700 Medical Ctr Rd
Mission Viejo, CA 92691-6426
Phone (949) 364-1400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A123908CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Western Anesthesia Medical Associates Inc Anesthesiology CurrentSince Jul 1, 2016 Accepting new patients

Locations

23025 Mill Creek Dr
Ste 203
Laguna Hills, CA 92653

27700 Medical Center Rd
Mission Viejo, CA 92691
Phone (949) 364-7744

27700 Medical Center Rd
Ste 171
Mission Viejo, CA 92691

1441 Avocado Ave
Ste 103
Newport Beach, CA 92660
Phone (949) 718-3600

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1300665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467676800000",
    "number": "1942509674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4077 FIFTH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032105",
            "telephone_number": "619-260-7220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4077 FIFTH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032105",
            "telephone_number": "619-260-7220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCUS",
        "first_name": "KEVIN",
        "middle_name": "DARROW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-21",
        "last_updated": "2016-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A123908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.