Individual provider Active NPI

Stephen E Cummings, M.D.

  • Psychiatry Physician
  • Redwood City, CA
National Provider Identifier
1063567063
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
G75318 Issued in CA
Practice address
617 Veterans Blvd Ste 116
Redwood City, CA 94063-1404
Phone
(650) 206-8670
NPI assigned
Jan 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X G75318 CA Primary

Addresses

Primary practice location

617 Veterans Blvd Ste 116
Redwood City, CA 94063-1404

Mailing address

617 Veterans Blvd Ste 116
Redwood City, CA 94063-1404
Phone (650) 206-8670

Other practice location 1

29632 E Highway 299
Suite Med, 340B00984300HC
Round Mountain, CA 96084
Phone (530) 337-6243

Other identifiers 1

IdentifierTypeStateIssuer
00G753180MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081118000642 CA Practitioner - Psychiatry 7618037839 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of California, Davis School of Medicine, 1999
Medicare assignment
May accept Medicare assignment
Group practices
Hill Country Community ClinicGroup PAC ID 1052442175, 19 clinicians

Practice addresses (Care Compare)

29632 E Hwy 299
Round Mountain, CA 96084-8000
Phone (530) 337-5750

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G75318CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pallas Medical Services CurrentSince Sep 11, 2022 Accepting new patients
Hill Country Community Clinic CurrentSince Aug 21, 2023 Accepting new patients
Hill Country Community Clinic CurrentSince Aug 21, 2023 Accepting new patients
County of San Mateo CurrentSince Jul 1, 2007 Accepting new patients
County of San Mateo Current Accepting new patients
County of San Mateo CurrentSince Jul 1, 2007 Accepting new patients
Hill Country Community Clinic Past Accepting new patients

Locations

1401 Gold St
Redding, CA 96001
Phone (530) 238-7133

617 Veterans Blvd
Ste 116
Redwood City, CA 94063
Phone (650) 206-8670

29632 E Highway 299
Round Mtn, CA 96084
Phone (530) 337-5750

222 W 39th Ave
San Mateo, CA 94403
Phone (415) 573-2222

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1063567063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 VETERANS BLVD STE 116",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940631404",
            "telephone_number": "650-206-8670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 VETERANS BLVD STE 116",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940631404",
            "telephone_number": "650-206-8670"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29632 E Highway 299",
            "address_2": "Suite Med, 340B00984300HC",
            "address_purpose": "LOCATION",
            "city": "Round Mountain",
            "state": "CA",
            "postal_code": "96084",
            "country_code": "US",
            "telephone_number": "530-337-6243",
            "fax_number": "530-337-6655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUMMINGS",
        "first_name": "STEPHEN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G75318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G753180",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redwood City, CA

Sources for this page

Verify at the official NPI Registry.