MARILYN TADIAMAN PUDOL
NPI 1720573439
Nurse Practitioner - Family in El Segundo, CA

Q: What is Marilyn Pudol's NPI number?

The NPI number for Marilyn Pudol is 1720573439. It was assigned to this individual provider in the NPPES registry on June 25, 2018.

Q: What is Marilyn Pudol's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Marilyn Pudol was last updated on October 24, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.

Active since June 25, 2018PECOS Enrolled

2101 ROSECRANS AVE # 3230, EL SEGUNDO, CA 90245(323) 628-8671 Get Directions Write a Review

NPPES record last updated: October 24, 2019. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Oct 24, 2019, Jun 25, 2018 (2 updates tracked since 2018).

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About Marilyn Tadiaman Pudol NPPES

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

MARILYN TADIAMAN PUDOL (NPI 1720573439) is an individual family provider in El Segundo, California, licensed in California (95008725) and active in the NPI registry since June 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1720573439

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameMARILYN TADIAMAN PUDOL

Location Address2101 ROSECRANS AVE # 3230El Segundo, CA 90245-4749

Mailing Address3056 Fletcher DrLos Angeles, CA 90065-2207 · (323) 256-2231

Phone(323) 628-8671

Sole ProprietorYes

Enumeration DateJune 25, 2018

Last NPPES UpdateOctober 24, 20192 updates tracked since enumeration

✔ NPI 1720573439 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in CA · 95008725

2101 ROSECRANS AVE # 3230, El Segundo, CA 90245

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Marilyn Tadiaman Pudol is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90245 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$96.36 typical visit price

range $62.96 – $187.60

Typical copayment $24.09 (range $15.74 – $46.90)

Most-billed visit code 99203

Established Patient

$109.96 typical visit price

range $20.84 – $153.61

Typical copayment $27.49 (range $5.21 – $38.40)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 18

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

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Nurse Practitioner (Family)