NPIMap

Organization Active NPI

CHW Medical Foundation

Doing business as Mercy Imaging Centers, a Service of CHW Medical Foundation

  • Multi-Specialty Clinic/Center
  • Sacramento, CA
National Provider Identifier
1114958139
Registry record updated Nov 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
CHW MEDICAL FOUNDATION
Doing business as
Mercy Imaging Centers, a Service of CHW Medical Foundation
Practice address
7500 Hospital Dr
Sacramento, CA 95823-5403
Phone
(916) 423-6176
Fax
(916) 423-5956
NPI assigned
Jul 6, 2006
Last updated
Nov 18, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
CHW MEDICAL FOUNDATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 18, 2020

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

Authorized official

Name
Theresa M Hylen
Title
Chief Financial Officer
Phone
(916) 851-2559

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

7500 Hospital Dr
Sacramento, CA 95823-5403

Mailing address

3000 Q St
Sacramento, CA 95816-7058
Phone (916) 733-5701

Other identifiers 2

IdentifierTypeStateIssuer
GR001137FOtherCAMEDI-CAL
ZZZ43878ZOtherCABLUE SHIELD

Other names 1

  • Mercy Imaging Centers, a Service of CHW Medical Foundation Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031107000709 CA Part B Supplier - Clinic/Group Practice 7810800661 Receives reassigned benefits from 1,333 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Part of
Woodland Clinic Med GRP

Practitioners & affiliated clinicians

Practitioners 11

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": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605657600000",
    "number": "1114958139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 Q ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958167058",
            "telephone_number": "916-733-5701",
            "fax_number": "916-733-3401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 HOSPITAL DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958235403",
            "telephone_number": "916-423-6176",
            "fax_number": "916-423-5956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHW MEDICAL FOUNDATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHW MEDICAL FOUNDATION",
        "enumeration_date": "2006-07-06",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A",
        "authorized_official_last_name": "HYLEN",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "916-851-2559"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "GR001137F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ43878Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Imaging Centers, a Service of CHW Medical Foundation",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mercy Imaging Centers, a Service of CHW Medical Foundation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; 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.