NPIMap

Organization Active NPI

Planned Parenthood Mar Monte, Inc

  • Community Health Clinic/Center
  • Stockton, CA
National Provider Identifier
1174579957
Registry record updated Jul 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
License
030000075 Issued in CA
Legal business name
PLANNED PARENTHOOD MAR MONTE, INC
Practice address
678 N Wilson Way
Suite G
Stockton, CA 95205-4272
Phone
(209) 466-2081
Fax
(209) 466-2083
NPI assigned
May 25, 2006
Last updated
Jul 25, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2019

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

Authorized official

Name
Mr. Tom Motsiff, MHA,CMA
Title
Cfo
Phone
(408) 795-3707

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X 030000075 CA Primary

Addresses

Primary practice location

678 N Wilson Way
Suite G
Stockton, CA 95205-4272

Mailing address

1691 The Alameda
San Jose, CA 95126-2203
Phone (408) 795-3600

Other identifiers 1

IdentifierTypeStateIssuer
ZZR11607GMedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040301000438 CA Part B Supplier - Clinic/Group Practice 1456248954 Receives reassigned benefits from 197 practitioners
32 other NPIs on this enrollment
Practice locations: Salinas, CA; Yuba City, CA; San Jose, CA; Seaside, CA; Stockton, CA; Tracy, CA; Watsonville, CA; Woodland, CA…

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 26

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 26

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 207

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.

View all 207

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564012800000",
    "number": "1174579957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1691 THE ALAMEDA",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951262203",
            "telephone_number": "408-795-3600",
            "fax_number": "408-971-6935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "678 N WILSON WAY",
            "address_2": "SUITE G",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952054272",
            "telephone_number": "209-466-2081",
            "fax_number": "209-466-2083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLANNED PARENTHOOD MAR MONTE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2019-07-25",
        "status": "A",
        "authorized_official_last_name": "MOTSIFF",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "408-795-3707",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MHA,CMA"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "CA",
            "license": "030000075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZR11607G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2019; 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.