Organization Active NPI

Adema Family Medicine, Inc

  • Family Medicine Physician
  • Santee, CA
National Provider Identifier
1043497316
Registry record updated Jan 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A6239 Issued in CA
Legal business name
ADEMA FAMILY MEDICINE, INC
Practice address
10201 Mission Gorge Rd Ste C
Santee, CA 92071-3026
Phone
(619) 596-5445
Fax
(619) 596-6923
NPI assigned
Jan 29, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2008

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

Authorized official

Name
Donald S Adema, D.O.NPI 1487763512
Title
Ceo
Phone
(619) 596-5445

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 20A6239 CA Primary

Addresses

Primary practice location

10201 Mission Gorge Rd Ste C
Santee, CA 92071-3026

Mailing address

10201 Mission Gorge Rd Ste C
Santee, CA 92071-3026
Phone (619) 596-5445

Other identifiers 1

IdentifierTypeStateIssuer
2OA6239OtherCASTATE LICENSE CA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080317000593 CA Part B Supplier - Clinic/Group Practice 8426133380 Receives reassigned benefits from 1 practitioner
Practice locations: Santee, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D1078437Adema Family Medicine10201 Mission Gorge Rd # M, Santee, CA 92071Certificate of waiverJan 8, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1201564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201564800000",
    "number": "1043497316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10201 MISSION GORGE RD STE C",
            "city": "SANTEE",
            "state": "CA",
            "postal_code": "920713026",
            "telephone_number": "619-596-5445",
            "fax_number": "619-596-6923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10201 MISSION GORGE RD STE C",
            "city": "SANTEE",
            "state": "CA",
            "postal_code": "920713026",
            "telephone_number": "619-596-5445",
            "fax_number": "619-596-6923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADEMA FAMILY MEDICINE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-29",
        "last_updated": "2008-01-29",
        "status": "A",
        "authorized_official_last_name": "ADEMA",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "619-596-5445",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A6239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE  CA",
            "identifier": "2OA6239",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santee, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.