Larry Marianella, Md A Professional Corp. - Medicare Primary Care in Santa Rosa, CA

Larry Marianella, Md A Professional Corp. is a medicare enrolled primary clinic (Internal Medicine) in Santa Rosa, California. The current practice location for Larry Marianella, Md A Professional Corp. is 1515 Montgomery Dr, Santa Rosa, California. For appointments, you can reach them via phone at (707) 526-4865. The mailing address for Larry Marianella, Md A Professional Corp. is 1515 Montgomery Dr, Santa Rosa, California and phone number is (707) 526-4865.

Larry Marianella, Md A Professional Corp. is licensed to practice in California (license number G38835). The clinic also participates in the medicare program and its NPI number is 1104128941. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (707) 526-4865.

Contact Information

Larry Marianella, Md A Professional Corp.
1515 Montgomery Dr
Santa Rosa
CA 95405-4500
(707) 526-4865
(707) 526-5375

Primary Care Clinic Profile

Full NameLarry Marianella, Md A Professional Corp.
SpecialityInternal Medicine
Location1515 Montgomery Dr, Santa Rosa, California
Authorized Official Name and PositionLarry Marianella (PRESIDENT)
Authorized Official Contact7075264865
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Larry Marianella, Md A Professional Corp.
1515 Montgomery Dr
Santa Rosa
CA 95405-4500

Ph: (707) 526-4865
Larry Marianella, Md A Professional Corp.
1515 Montgomery Dr
Santa Rosa
CA 95405-4500

Ph: (707) 526-4865

NPI Details:

NPI Number1104128941
Provider Enumeration Date11/30/2010
Last Update Date11/30/2010

Medicare PECOS Information:

Medicare PECOS PAC ID8224224274
Medicare Enrollment IDO20101202000339

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Medical Identifiers

Medical identifiers for Larry Marianella, Md A Professional Corp. such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1104128941NPI-NPPES
00G388351MedicaidCA

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207R00000XInternal Medicine G38835 (California)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Larry Marianella, Md A Professional Corp. acts as a billing entity for following providers:
Provider NameLarry Marianella
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1144257486
PECOS PAC ID: 7012103070
Enrollment ID: I20101202000395

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