MARCUS MIYABARA
NPI 1710341383
Student in an Organized Health Care Education/Training Program in San Diego, CA

Active since April 11, 2016PECOS EnrolledAccepts Medicare Assignment
4077 FIFTH AVE # MER35, SAN DIEGO, CA 92103(833) 574-2273 Get Directions Write a Review

NPPES record last updated: December 3, 2021. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Dec 3, 2021, May 18, 2021 (2 updates tracked since 2021).

About Marcus Miyabara NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARCUS MIYABARA (NPI 1710341383) is an individual student in an organized health care education/training program in San Diego, California and active in the NPI registry since April 2016. He is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1710341383
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameMARCUS MIYABARA
Location Address4077 FIFTH AVE # MER35San Diego, CA 92103-2105
Mailing Address2531 Chester AveBakersfield, CA 93301-2012
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateApril 11, 2016
Last NPPES UpdateDecember 3, 20212 updates tracked since enumeration
NPPES CertifiedMay 18, 2021
NPI 1710341383 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
4077 FIFTH AVE # MER35, San Diego, CA 92103

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Marcus Miyabara is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID143550434
PECOS Enrollment IDI20190930002401
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Internal Medicine
4077 FIFTH AVE # MER35
SAN DIEGO, CA 92103
Internal Medicine
4077 FIFTH AVE # MER35
SAN DIEGO, CA 92103
Internal Medicine
4077 FIFTH AVE # MER35
SAN DIEGO, CA 92103
Internal Medicine
4077 FIFTH AVE # MER35
SAN DIEGO, CA 92103
Internal Medicine
4077 FIFTH AVE # MER35
SAN DIEGO, CA 92103
Internal Medicine
4077 FIFTH AVE # MER35
SAN DIEGO, CA 92103
Internal Medicine
4077 FIFTH AVE # MER35
SAN DIEGO, CA 92103
Student in an Organized Health Care Education/Training Program
4077 FIFTH AVE # MER35
SAN DIEGO, CA 92103

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Marcus Miyabara's NPI number?

The NPI number for Marcus Miyabara is 1710341383. It was assigned to this individual provider in the NPPES registry on April 11, 2016.

Where is Marcus Miyabara located?

Marcus Miyabara practices at 4077 Fifth Ave # Mer35, San Diego, CA 92103. The listed phone number is (833) 574-2273.

What is Marcus Miyabara's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Marcus Miyabara enrolled in Medicare?

Yes. Marcus Miyabara is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Marcus Miyabara was last updated on December 3, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.