Organization Active NPI

Cardiovascular Associates of Santa Cruz

  • Cardiovascular Disease Physician
  • Santa Cruz, CA
National Provider Identifier
1063858058
Registry record updated Aug 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
G73261 Issued in CA
Legal business name
CARDIOVASCULAR ASSOCIATES OF SANTA CRUZ
Practice address
1595 Soquel Drive
Suite 220
Santa Cruz, CA 95065-1560
Phone
(831) 464-3801
Fax
(831) 464-2737
NPI assigned
May 16, 2013
Last updated
Aug 5, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2013

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

Authorized official

Name
Dr. Jay A Johnson, M.D.NPI 1699810697
Title
Owner/Partner
Phone
(831) 334-2316

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
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X G73261 CA Primary

Addresses

Primary practice location

1595 Soquel Drive
Suite 220
Santa Cruz, CA 95065-1560

Mailing address

1595 Soquel Drive
Suite 220
Santa Cruz, CA 95065-1560
Phone (831) 464-3801

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130809000198 CA Part B Supplier - Clinic/Group Practice 9931341674 Receives reassigned benefits from 4 practitioners
Practice locations: Santa Cruz, CA

National Provider Directory

National Provider Directory

Locations

1595 Soquel Dr
Ste 220
Santa Cruz, CA 95065
Phone (831) 464-3801

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1368662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375660800000",
    "number": "1063858058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1595 SOQUEL DRIVE",
            "address_2": "SUITE 220",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651560",
            "telephone_number": "831-464-3801",
            "fax_number": "831-464-2737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1595 SOQUEL DRIVE",
            "address_2": "SUITE 220",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651560",
            "telephone_number": "831-464-3801",
            "fax_number": "831-464-2737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIOVASCULAR ASSOCIATES OF SANTA CRUZ",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-16",
        "last_updated": "2013-08-05",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/PARTNER",
        "authorized_official_telephone_number": "831-334-2316",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "G73261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.