Individual provider Active NPI

Matthew Kalev Golubjatnikov

  • Emergency Medicine Physician
  • Stockton, CA
National Provider Identifier
1245970722
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A188136 Issued in CA
Practice address
1800 N California St
Stockton, CA 95204-6019
Phone
(209) 547-7146
NPI assigned
Mar 31, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A188136 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1800 N California St
Stockton, CA 95204-6019

Mailing address

1800 N California St
Stockton, CA 95204-6019

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
I20250124001750 CA Practitioner - Emergency Medicine 4688103369 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physicians Associates Fremont PCGroup PAC ID 8527303585, 32 clinicians
Emergency Physicians Associates San Jose PCGroup PAC ID 8921344292, 131 clinicians

Practice addresses (Care Compare)

2000 Mowry Ave
Fremont, CA 94538-1716
Phone (510) 797-1111

225 N Jackson Ave
San Jose, CA 95116-1603
Phone (408) 259-5000

Hospital & facility affiliations

  • Santa Clara Valley Medical Center Hospital, San Jose, CA, CCN 050038
  • Washington Hospital Hospital, Fremont, CA, CCN 050195

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A188136CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians Associates San Jose PC Emergency Medicine CurrentSince Jul 1, 2025 Accepting new patients
Cep America-California Emergency Medicine CurrentSince Jan 1, 2025 Accepting new patients
Cep America - California Emergency Medicine CurrentSince Jan 1, 2025 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients
Emergency Physicians Associates Fremont PC Emergency Medicine CurrentSince Jul 1, 2025 Accepting new patients

Locations

3901 Lone Tree Way
Antioch, CA 94509
Phone (925) 779-7200

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

2000 Mowry Ave
Fremont, CA 94538
Phone (510) 793-6653

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

2105 Forest Ave
San Jose, CA 95128
Phone (408) 947-2500

225 N Jackson Ave
San Jose, CA 95116
Phone (408) 347-4051

Interoperability endpoints

  • Direct secure messaging: mgolubjatnikov722115@hisp.ehr.sutterhealth.org
  • Direct secure messaging: mgolubjatnikov235325@santaclaravalley.direct-ci.net

Organizations & group practices 5

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 2

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": "1648684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1245970722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 N CALIFORNIA ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 N CALIFORNIA ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046019",
            "telephone_number": "209-547-7146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLUBJATNIKOV",
        "first_name": "MATTHEW",
        "middle_name": "KALEV",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-31",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A188136",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.