Individual provider Active NPI

Chad Michael Craig, M.D.

  • Internal Medicine Physician
  • Santa Monica, CA
National Provider Identifier
1174767867
Registry record updated Dec 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A104175 Issued in CA
Practice address
1260 15TH St Ste 1502
Santa Monica, CA 90404-1135
Phone
(310) 656-1702
NPI assigned
Apr 24, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 257925 NY
Internal Medicine Physician 207R00000X ME158229 FL
Internal Medicine Physician 207R00000X A104175 CA Primary

Addresses

Primary practice location

1260 15TH St Ste 1502
Santa Monica, CA 90404-1135

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

Other practice location 1

11738 Mayfield Ave Apt 112
Los Angeles, CA 90049-5786
Phone (617) 216-8811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100929000120 NY Practitioner - Internal Medicine 1355480955 Reassigns benefits to 1 organization
I20201125002548 WI Practitioner - HospitalistPractitioner - Internal Medicine 1355480955 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Boston University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5767 W Century Blvd
Suite 400
Los Angeles, CA 90045-5631

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A104175CAMDInternal Medicine Physician
ME158229FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MCHS Hospitals Inc Internal Medicine CurrentSince Oct 26, 2020 Accepting new patients
New York Society for the Relief of Ruptured & Crippled Maintaining CurrentSince Feb 3, 2014 Accepting new patients
Marshfield Clinic Inc CurrentSince Oct 26, 2020 Accepting new patients
MCHS Hospitals Inc CurrentSince Oct 26, 2020 Accepting new patients
New York Society for the Relief of Ruptured & Crippled Maintaining CurrentSince Feb 3, 2014 Accepting new patients
Mount Sinai Diagnostic and Treatment Center Past Accepting new patients
Trustees of Columbia University in the City of New York Internal Medicine Past Accepting new patients

Locations

535 E 70th St
New York, NY 10021

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

3501 Cranberry Blvd
Weston, WI 54476
Phone (715) 393-1000

Interoperability endpoints

  • FHIR API: https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/DSTU2
  • FHIR API: https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 7

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": "1240531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764547200000",
    "number": "1174767867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 15TH ST STE 1502",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904041135",
            "telephone_number": "310-656-1702"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11738 Mayfield Ave Apt 112",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900495786",
            "country_code": "US",
            "telephone_number": "617-216-8811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRAIG",
        "first_name": "CHAD",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-24",
        "last_updated": "2025-12-01",
        "certification_date": "2025-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "257925",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME158229",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A104175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.