MARILYN TADIAMAN PUDOL
NPI 1720573439
Nurse Practitioner - Family in El Segundo, CA
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, maintains a secondary practice location in Los Angeles, and is a graduate of Other (2017).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Marilyn Tadiaman Pudol 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.
Medicare Billing Reassignment
Medicare enrollment records show Marilyn Pudol reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
El Segundo, CA 90245
- Reassigned Medicare billing, California enrollment
- 56 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
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.
EL SEGUNDO, CA 90245
EL SEGUNDO, CA 90245
EL SEGUNDO, CA 90245
EL SEGUNDO, CA 90245
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 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.
Where is Marilyn Pudol located?
Marilyn Pudol practices at 2101 Rosecrans Ave # 3230, El Segundo, CA 90245. The listed phone number is (323) 628-8671.
What is Marilyn Pudol's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Marilyn Pudol enrolled in Medicare?
Yes. Marilyn Pudol 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.
Which organization bills Medicare for Marilyn Pudol's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Marilyn Pudol reassigns Medicare benefits to Greater Good Health PC, Inc. (El Segundo, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Marilyn Pudol's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
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 7 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.
# Marilyn Tadiaman Pudol · NPI 1720573439
Family physician in El Segundo, California. Individual provider, active in the CMS NPPES registry since June 25, 2018.
## Identity
- **NPI:** 1720573439 (Entity type: Individual)
- **Enumerated:** June 25, 2018
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 95008725 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 2101 ROSECRANS AVE # 3230, El Segundo, CA 90245-4749
- **Phone:** (323) 628-8671
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Greater Good Health PC, Inc. (NPI 1821673005, El Segundo, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2017
## Record status
- **NPPES last updated:** October 24, 2019
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Source: [NPI Profile](https://npiprofile.com/npi/1720573439) · Data from the CMS NPPES public registry.