NPIMap

Individual provider Active NPI

Andre' Van Mol, MD

  • Family Medicine Physician
  • Redding, CA
National Provider Identifier
1083603203
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G62379 Issued in CA
Practice address
1755 Court St
Redding, CA 96001-1721
Phone
(530) 247-8800
Fax
(530) 241-1174
NPI assigned
Oct 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G62379 CA Primary

Addresses

Primary practice location

1755 Court St
Redding, CA 96001-1721

Mailing address

3400 Data Dr
Attn: Credentialing/Payer Enrollment
Rancho Cordova, CA 95670-7956

Other identifiers 2

IdentifierTypeStateIssuer
00G623790MedicaidCA
68-0484253OtherCATAX PAYER ID

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070202000495 CA Practitioner - Family Practice 2961404033 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Practice addresses (Care Compare)

1755 Court St
Redding, CA 96001-1721
Phone (530) 243-3339

Hospital & facility affiliations

  • Valley View Healthcare Services LLC Home health agency, Chico, CA, CCN 559751
  • Northstar Healthcare Services Home health agency, Sacramento, CA, CCN 757243
  • Mercy Home Care Home health agency, Redding, CA, CCN 057609
  • Mission Home Health of Redding Home health agency, Redding, CA, CCN 059579
  • Medical Home Care Professionals Home health agency, Redding, CA, CCN 557107
  • Oroville Hospital Hospital, Oroville, CA, CCN 050030
  • Mercy Medical Center Redding Hospital, Redding, CA, CCN 050280
  • Fairchild Medical Center Hospital, Yreka, CA, CCN 051316

Merit-based Incentive Payment System (MIPS)

Final score
99.64 of 100Reported as apm
Quality
86.27
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions20
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Medical Foundation CurrentSince Feb 12, 2018 Accepting new patients
Dignity Health Medical Foundation Current Accepting new patients
Dignity Health Past Accepting new patients
Shasta Regional Medical Center, LLC Past Accepting new patients

Locations

1755 Court St
Redding, CA 96001
Phone (530) 241-8633

2510 Airpark Dr
Ste 301
Redding, CA 96001
Phone (530) 242-3500

3400 Data Dr
Rncho Cordova, CA 95670
Phone (916) 379-2726

Organizations & group practices 4

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1083603203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "address_2": "ATTN: CREDENTIALING/PAYER ENROLLMENT",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 COURT ST",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960011721",
            "telephone_number": "530-247-8800",
            "fax_number": "530-241-1174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN MOL",
        "first_name": "ANDRE'",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G62379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G623790",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX PAYER ID",
            "identifier": "68-0484253",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

Verify at the official NPI Registry.