Individual provider Active NPI

Marilyn Siegel Boettiger, LCSW

  • Clinical Social Worker
  • Irvine, CA
National Provider Identifier
1992871651
Registry record updated May 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS8176 Issued in CA
Practice address
13 Hawkridge
Irvine, CA 92604-4611
Phone
(949) 552-8737
Fax
(949) 654-2402
NPI assigned
Nov 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS8176 CA Primary

Addresses

Primary practice location

13 Hawkridge
Irvine, CA 92604-4611

Mailing address

13 Hawkridge
Irvine, CA 92604-4611
Phone (949) 552-8737

Other identifiers 1

IdentifierTypeStateIssuer
CSW081760MedicaidCA

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100720000916 CA Practitioner - Clinical Social Worker 9234261694 Practice locations: Newport Beach, CA; Sacramento, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1000 Quail St
Suite 250
Newport Beach, CA 92660-2784
Phone (949) 552-8737

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

NPI Registry JSON

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273449600000",
    "number": "1992871651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 HAWKRIDGE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926044611",
            "telephone_number": "949-552-8737",
            "fax_number": "949-654-2402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 HAWKRIDGE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926044611",
            "telephone_number": "949-552-8737",
            "fax_number": "949-654-2402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOETTIGER",
        "first_name": "MARILYN",
        "middle_name": "SIEGEL",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-27",
        "last_updated": "2010-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS8176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CSW081760",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.