Individual provider Active NPI

Tina Molumphy, MD

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Los Gatos, CA
National Provider Identifier
1124057930
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
A60923 Issued in CA
Practice address
340 Dardanelli LN Ste 10
Los Gatos, CA 95032-1418
Phone
(408) 412-8100
Fax
(408) 412-8499
NPI assigned
Jul 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X A60923 CA Primary

Addresses

Primary practice location

340 Dardanelli LN Ste 10
Los Gatos, CA 95032-1418

Mailing address

851 Fremont Ave.
Suite 109
Los Altos, CA 94024-5620
Phone (650) 941-1040

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
I20070521000483 CA Practitioner - Pain Management 0648377994 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pain Management
Education
Tulane University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Golden State Orthopedics and SpineGroup PAC ID 8224940739, 186 clinicians

Practice addresses (Care Compare)

2405 Shadelands Dr
Walnut Creek, CA 94598-2444
Phone (925) 939-8585

2625 Shadelands Dr
Walnut Creek, CA 94598-2512
Phone (925) 939-8585

340 Dardanelli LN
Suite 10
Los Gatos, CA 95032-1418
Phone (408) 412-8100

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A60923CAMDPain Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Golden State Orthopedics & Spine CurrentSince Jan 1, 2022 Accepting new patients
Orthonorcal, Inc. CurrentSince Jan 2, 2020 Accepting new patients
Golden State Orthopedics & Spine Current Accepting new patients
Orthonorcal Inc CurrentSince Jan 2, 2020 Accepting new patients
Golden State Orthopedics & Spine CurrentSince Jan 1, 2022 Accepting new patients
Golden State Orthopedics & Spine Past Accepting new patients
Good Samaritan Hospital, L.P. Past Accepting new patients
County of Santa Clara Past Accepting new patients
El Camino Hospital Past Accepting new patients

Locations

340 Dardanelli Ln
Ste 10
Los Gatos, CA 95032
Phone (408) 412-8100

340 Dardanelli Ln
Ste 102
Los Gatos, CA 95032
Phone (408) 412-8131

340 Dardanelli Ln
Ste 108
Los Gatos, CA 95032

2405 Shadelands Dr
Walnut Creek, CA 94598
Phone (615) 930-0820

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: tina.molumphy.p1@direct.orthonorcal.nextgenshare.com
  • Direct secure messaging: tina.molumphy.p2@direct.muirortho.nextgenshare.com

Organizations & group practices 9

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": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1124057930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "851 FREMONT AVE.",
            "address_2": "SUITE 109",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940245620",
            "telephone_number": "650-941-1040",
            "fax_number": "650-941-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 DARDANELLI LN STE 10",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950321418",
            "telephone_number": "408-412-8100",
            "fax_number": "408-412-8499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLUMPHY",
        "first_name": "TINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-02",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "CA",
            "license": "A60923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Gatos, CA

Sources for this page

Verify at the official NPI Registry.