NPIMap

Organization Active NPI

Shasta Critical Care Specialists Medical Clinic, Inc.

  • Critical Care Medicine (Internal Medicine) Physician
  • Redding, CA
National Provider Identifier
1245249770
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
Legal business name
SHASTA CRITICAL CARE SPECIALISTS MEDICAL CLINIC, INC.
Practice address
2701 Old Eureka Way
Suite 1E
Redding, CA 96001-0228
Phone
(530) 232-3000
Fax
(530) 232-3099
NPI assigned
Aug 5, 2006
Last updated
Oct 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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

Authorized official

Name
Rafael LupercioNPI 1174532618
Title
Authorized Official
Phone
(530) 232-3000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X CA Primary
Nephrology Physician 207RN0300X CA
Pulmonary Disease Physician 207RP1001X CA

Addresses

Primary practice location

2701 Old Eureka Way
Suite 1E
Redding, CA 96001-0228

Mailing address

2701 Old Eureka Way Ste 1E
Redding, CA 96001-0228
Phone (530) 232-3000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050103000647 CA Part B Supplier - Clinic/Group Practice 0547228884 Receives reassigned benefits from 11 practitioners
Practice locations: Redding, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D1019618Shasta Critical Care Specialists2701 Old Eureka Way Ste 1-E, Redding, CA 96001Provider-performed microscopyNov 20, 2027

National Provider Directory

National Provider Directory

Locations

2701 Old Eureka Way
Ste 1E
Redding, CA 96001
Phone (530) 232-3000

2701 Old Eureka Way
Ste 1J
Redding, CA 96001
Phone (530) 232-3000

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": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727827200000",
    "number": "1245249770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 OLD EUREKA WAY STE 1E",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960010228",
            "telephone_number": "530-232-3000",
            "fax_number": "530-242-8545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 OLD EUREKA WAY",
            "address_2": "SUITE 1E",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960010228",
            "telephone_number": "530-232-3000",
            "fax_number": "530-232-3099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHASTA CRITICAL CARE SPECIALISTS MEDICAL CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A",
        "authorized_official_last_name": "LUPERCIO",
        "authorized_official_first_name": "RAFAEL",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "530-232-3000"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.