Individual provider Active NPI

Rachael Maciasz

  • Hospitalist Physician
  • Santa Monica, CA
National Provider Identifier
1972940013
Registry record updated Sep 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
A150059 Issued in CA
Practice address
2336 Santa Monica Blvd Ste 301
Santa Monica, CA 90404-2067
Phone
(310) 998-9118
Fax
(310) 829-9318
NPI assigned
May 30, 2013
Last updated
Sep 4, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A150059 CA
Pediatrics Physician 208000000X LP02837 RI
Hospitalist Physician 208M00000X A150059 CA Primary

Addresses

Primary practice location

2336 Santa Monica Blvd Ste 301
Santa Monica, CA 90404-2067

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

Other practice location 1

1250 16th St # C2304
Santa Monica, CA 90404-1249
Phone (310) 319-4698

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LP02837RIMDPediatrics Physician
A150059CAMDHospitalist Physician

NPI Registry JSON

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

{
    "created_epoch": "1369872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567555200000",
    "number": "1972940013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2336 SANTA MONICA BLVD STE 301",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042067",
            "telephone_number": "310-998-9118",
            "fax_number": "310-829-9318"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1250 16th St # C2304",
            "address_purpose": "LOCATION",
            "city": "Santa Monica",
            "state": "CA",
            "postal_code": "904041249",
            "country_code": "US",
            "telephone_number": "310-319-4698",
            "fax_number": "310-319-4908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACIASZ",
        "first_name": "RACHAEL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-30",
        "last_updated": "2019-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A150059",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "RI",
            "license": "LP02837",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A150059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.