Maxine Inocencio, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

A158147 Issued in CA

Practice address

1900 Sullivan Ave
Daly City, CA 94015-2200

Phone

(650) 992-4000

NPI assigned

Mar 31, 2016

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

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

Specialty

Emergency Medicine

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pacific Coast Emergency Medical Associates, IncGroup PAC ID 5092861054, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• College Medical Center Hospital, Long Beach, CA, CCN 050776

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Pacific Coast Emergency Medical Associates, Inc

  • Emergency Medicine Physician
  • Long Beach, CA
  • NPI 1316179492
  Medicare reassignment Care Compare group NPD
• Alvarado Emergency Medical Associates, Inc.

  • Emergency Medicine Physician
  • San Diego, CA
  • NPI 1285811992
  Medicare reassignment NPD
• Carbon Health Medical Group of California PC

  • Urgent Care Clinic/Center
  • Berkeley, CA
  • NPI 1417294232
  NPD (past)

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

• CHLB, LLC

  • General Acute Care Hospital
  • Long Beach, CA
  • NPI 1215373626
  Care Compare affiliation

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

{
    "created_epoch": "1459382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579219200000",
    "number": "1952764599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80119",
            "city": "CITY OF INDUSTRY",
            "state": "CA",
            "postal_code": "917168119",
            "telephone_number": "866-267-2984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 SULLIVAN AVE",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940152200",
            "telephone_number": "650-992-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INOCENCIO",
        "first_name": "MAXINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-31",
        "last_updated": "2020-01-17",
        "certification_date": "2020-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A158147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Icaza
• Shammah Ibukun Ike, MD
• Imagineecho LLC
• Impaq Home Health, Inc
• Stephanie Kiyoko Inaba, MS, CCC-SLP
• Insite Digestive Health Care
• International Rehabilitation Institute
• Monica Lynn Ippolito, MA
• Timothy Frederick Isaacs, MD
• Varsha Ivanova, DPM

• Emergency Medicine Physician in Daly City, CA
• Providers in Daly City, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2020; 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.