NPIMap

Organization Active NPI

Northwest Valley Family Medical Clinic, Inc.

  • Family Medicine Physician
  • Santa Clarita, CA
National Provider Identifier
1255426383
Registry record updated Dec 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A70428 Issued in CA
Legal business name
NORTHWEST VALLEY FAMILY MEDICAL CLINIC, INC.
Practice address
17909 Soledad Canyon Rd # 100
Santa Clarita, CA 91387-3210
Phone
(661) 367-3500
NPI assigned
Oct 4, 2006
Last updated
Dec 19, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2022

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

Authorized official

Name
Dr. Martina Barte Masongsong, M.D.NPI 1962623652
Title
Vice-President
Phone
(818) 388-1951

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A70428 CA Primary

Addresses

Primary practice location

17909 Soledad Canyon Rd # 100
Santa Clarita, CA 91387-3210

Mailing address

19182 Dunure Place
Northridge, CA 91326
Phone (818) 368-2859

Other identifiers 2

IdentifierTypeStateIssuer
GR0101260MedicaidCA
GR0101261MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address martina.masongsong@optum.optumcare.com

National Provider Directory

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: martina.masongsong@optum.optumcare.com

Practitioners & affiliated clinicians

Practitioners 3

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": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671408000000",
    "number": "1255426383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19182 DUNURE PLACE",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "91326",
            "telephone_number": "818-368-2859",
            "fax_number": "661-259-8295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17909 SOLEDAD CANYON RD # 100",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913873210",
            "telephone_number": "661-367-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST VALLEY FAMILY MEDICAL CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A",
        "authorized_official_last_name": "MASONGSONG",
        "authorized_official_first_name": "MARTINA",
        "authorized_official_middle_name": "BARTE",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "818-388-1951",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A70428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0101260",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0101261",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "martina.masongsong@optum.optumcare.com",
            "affiliation": "N",
            "address_1": "17909 Soledad Canyon Rd # 100",
            "city": "Santa Clarita",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913873210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Santa Clarita, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.