NPIMap

Individual provider Active NPI

Mirtha L Balcazar, M.D.

  • Family Medicine Physician
  • Cottonwood, CA
National Provider Identifier
1174515969
Registry record updated Feb 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A44843 Issued in CA
Practice address
20633 Gas Point Rd
Cottonwood, CA 96022-9296
Phone
(530) 347-4867
Fax
(530) 347-5670
NPI assigned
Aug 17, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2012

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 A44843 CA Primary

Addresses

Primary practice location

20633 Gas Point Rd
Cottonwood, CA 96022-9296

Mailing address

PO Box 496084
Redding, CA 96049-6084
Phone (530) 347-4867

Other identifiers 1

IdentifierTypeStateIssuer
00A448430MedicaidCA

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
I20040924000459 CA Practitioner - Internal MedicinePractitioner - Family Practice 7618886953 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Family Practice
Education
Other, 1979
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

Hospital & facility affiliations

  • Assured Home Health Home health agency, Redding, CA, CCN 058117
  • Accentcare Home Health of California, Inc Home health agency, Redding, CA, CCN 557273
  • Valley View Healthcare Services LLC Home health agency, Chico, CA, CCN 559751
  • Mercy Home Care Home health agency, Redding, CA, CCN 057609
  • Mission Home Health of Redding Home health agency, Redding, CA, CCN 059579
  • Mercy Medical Center Redding Hospital, Redding, CA, CCN 050280
  • Mayers Memorial Hospital Hospital, Fall River Mills, CA, CCN 051305

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44843CAMDDentist
A44843CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hill Country Community Clinic CurrentSince Jun 7, 2012 Accepting new patients
Hill Country Community Clinic CurrentSince Jun 7, 2012 Accepting new patients

Locations

1024 Mistletoe Ln
Ste B
Redding, CA 96002
Phone (530) 232-0845

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

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 7

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": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330041600000",
    "number": "1174515969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 496084",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960496084",
            "telephone_number": "530-347-4867",
            "fax_number": "530-347-5670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20633 GAS POINT RD",
            "city": "COTTONWOOD",
            "state": "CA",
            "postal_code": "960229296",
            "telephone_number": "530-347-4867",
            "fax_number": "530-347-5670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALCAZAR",
        "first_name": "MIRTHA",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-17",
        "last_updated": "2012-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A44843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A448430",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cottonwood, CA

Sources for this page

Verify at the official NPI Registry.