Individual provider Active NPI

Eduardo Jose Marcus, PA

  • Physician Assistant
  • Salinas, CA
National Provider Identifier
1962564708
Registry record updated Sep 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA20186 Issued in CA
Practice address
1441 Constitution Blvd BLDG 151
# 202
Salinas, CA 93906-3100
Phone
(831) 769-8640
Fax
(831) 769-8640
NPI assigned
Dec 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA20186 CA Primary

Addresses

Primary practice location

1441 Constitution Blvd BLDG 151
# 202
Salinas, CA 93906-3100

Mailing address

1110 La Terrace Cir
San Jose, CA 95123-5351
Phone (408) 323-9810

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181214002769 CA Order and Referring Only - Physician Assistant 2365592052

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
20186CAMDSpeech-Language Pathologist
PA20186CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Monterey County Behavioral Health Division Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410220800000",
    "number": "1962564708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 LA TERRACE CIR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951235351",
            "telephone_number": "408-323-9810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 CONSTITUTION BLVD BLDG 151",
            "address_2": "# 202",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "939063100",
            "telephone_number": "831-769-8640",
            "fax_number": "831-769-8640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCUS",
        "first_name": "EDUARDO",
        "middle_name": "JOSE",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2014-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA20186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salinas, CA

Sources for this page

Verify at the official NPI Registry.